What is step therapy?
Step therapy is an insurance rule that you try a cheaper drug first, and show it did not work or could not be tolerated, before the plan pays for a more expensive one such as Wegovy or Zepbound.
What the first step usually is
For weight loss the first drug is often phentermine, naltrexone-bupropion or orlistat. The plan's formulary lists the steps and how long each must be tried.
Two cash programs to check.
No insurance needed.
- Check price →
- Check price →SnagRx's homepage shows its 12-month prepaid prices first
How to get past it
Your prescriber can document why the first drug is unsafe or did not work, ask for an exception, or appeal a denial.
What it means for the price
While a plan holds you on a step, the GLP-1 is not covered. Paying cash skips the steps.
Questions
Can I skip step therapy?
Plans allow exceptions when the prescriber documents a medical reason. Ask the plan for its exception process.
Sources
Prices on GLP Chart are read from each program's own pricing page. How: how we check prices. Every program's price this month: the GLP-1 price index.