Does aetna cover semaglutide

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Does aetna cover semaglutide. Wegovy (semaglutide) is used to help people lose weight and maintain weight loss. Wegovy is a GLP-1 Agnonist, which works by increasing insulin release and reducing appetite. It is used with a reduced calorie diet and exercise. Wegovy is available as cartons of four prefilled pens. There is currently no generic alternative to Wegovy.

My understanding is if you’ve got a higher BMI with abnormal blood work (the high LDL), you qualify for metabolic syndrome diagnosis, which can help with getting coverage. I’m sure experiences can vary depending on carrier and employer. 1. Reply. Long_Profession_2618. • 2 yr. ago.

Reserve oral semaglutide (nonformulary) for those unable to use injectable therapy (e.g., dexterity or vision limitations, etc.). Consider other oral formulary agents before using oral semaglutide. 3. For patients with BMI greater or equal to 27kg/m2, empagliflozin is recommended as the second oral agent (to metformin), unless unable to use. 4.Ozempic ® (semaglutide) – New drug approval. December 5, 2017 – Novo Nordisk announced the FDA approval of Ozempic (semaglutide), as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM). Download PDF.Apr 22, 2024 · Novo Nordisk, the manufacturer of Ozempic, offers a copay assistance program for individuals with commercial insurance. Eligible patients pay as little as $25 for up to a 3-month supply of Ozempic. This program, however, does not apply to people using government-assisted programs such as Medicare or Medicaid. Apr 12, 2024 · Wegovy (semaglutide), a prescription medication for chronic weight management, has a list price of about $1,350 for a 28-day supply. This means that the medication could cost more than $16,000 per year without insurance or manufacturer discounts. Coverage for weight-loss medications like Wegovy varies widely depending on the kind of insurance ... 6. Dose does not exceed the FDA-approved maximum recommended dose (see Section V). Approval duration: 12 months B. Other diagnoses/indications 1. Refer to the off-label use policy for the relevant line of business if diagnosis is NOT specifically listed under section III (Diagnoses/Indications for which coverage isAs of an October 2022 report from the Institute for Clinical and Economic Review, a month's supply of Wegovy (semaglutide) ran $1,300. High costs leave patients asking, does insurance cover weight loss medication? Since drugs like tirzepatide and semaglutide are meant to be taken indefinitely, starting one is a financial commitment.Aetna Non-Medicare Prescription Drug Plan. Subject: GLP-1 Agonist Ozempic PA with Limit 2439-C 08-2021. Policy: FDA-approved Indications. Ozempic is indicated: as an adjunct …

Please check directly with the health plan to confirm coverage for individual patients. b Offer available only to commercially insured patients with RYBELSUS ® coverage. Month is defined as 30 days. Maximum savings of $300 per 1-month supply, $600 per 2-month supply, or $900 per 3-month supply. Semaglutide, sold under the brand names Ozempic and Wegovy has skyrocketed in use for its ability to aid weight loss. However, some companies are backing down from coverage due to their high cost ... 3. If request is for a dose increase, new dose does not exceed one of the following: a. Trulicity: i. If request is for dose increase from 1.5 mg, new dose does not exceed 3 mg per week (4 vials or pens per month); ii. If request is for dose increase from 3 mg, new dose does not exceed 4.5 mg per week (4 vials or pens per month); AETNA BETTER HEALTH® Coverage Policy/Guideline Name: Ozempic and Trulicity Effective Date: 1/3/2024 . Last Review Date: 11/2023 . Applies to: ☐Illinois ... If the …When it comes to hot tubs, one of the most important pieces of equipment is the cover. Not only does it keep out dirt and debris, but it also helps maintain the temperature of the ...Novo Nordisk, the manufacturer of Ozempic, offers a copay assistance program for individuals with commercial insurance. Eligible patients pay as little as $25 for up to a 3-month supply of Ozempic. This program, however, does not apply to people using government-assisted programs such as Medicare or Medicaid.Semaglutide was awarded the national contract 11/2/20 as the workhorse weekly GLP1A for new starts restricted to CFU. There is no requirement for switching patients. Decisions to do so can be made on an individual basis with provider and/or P&T input. SEMAGLUTIDE INJ,SOLN (Local Prior Authorization Required) is an item listed …In early June, the U.S. Food and Drug Administration approved semaglutide 2.4 mg (Wegovy) for chronic management of obesity and for those with a body mass index (BMI)* of 27 or greater in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes, or dyslipidemia). 1 Semaglutide is a member of the …

Nov 15, 2023 · The cost of Ozempic (semaglutide) with Medicare varies depending on your specific Medicare plan and coverage. This can range from a modest copayment, such as $10 to $50 per prescription, or a percentage of the medication cost, such as 20% coinsurance. Medicare Part B. • Wegovy contains semaglutide and should not be coadministered with other semaglutide- containing products or with any other GLP-1 receptor agonist. • The safety and effectiveness of Wegovy in combination with other products intended for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not When it comes to obesity drugs like Wegovy, a key question among Medicare recipients is whether their plan covers this type of medication. Currently, Medicare does not cover Wegovy. This exclusion stems from specific regulations within the Medicare framework. Wegovy, a brand-name version of Semaglutide marketed for weight loss, …Novo Nordisk sells semaglutide, a drug meant for treating diabetes and obesity. For diabetes, the brand name is Ozempic, which costs $892 every four weeks and is typically covered by payers for diabetic patients. Novo Nordisk also sells two weight loss drugs that are of the same class in two doses. Liraglutide is sold as Saxenda and …Wegovy ® (semaglutide) injection 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity: to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight.

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Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Wegovy, generically known as semaglutide, is an injectable medicine specifically approved for weight loss and long-term weight management for adults who are either obese or overweight with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. Diving into the specifics of Medicaid’s coverage ...A fax cover sheet should list who the fax is from, who the recipient is and the number of pages in the fax. The number of pages should include the cover sheet.As of an October 2022 report from the Institute for Clinical and Economic Review, a month's supply of Wegovy (semaglutide) ran $1,300. High costs leave patients asking, does insurance cover weight loss medication? Since drugs like tirzepatide and semaglutide are meant to be taken indefinitely, starting one is a financial commitment. • Wegovy contains semaglutide and should not be coadministered with other semaglutide-containing products or with any other GLP- 1 receptor agonist. • The safety and effectiveness of Wegovy in combination with other products intended for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been

Aetna Better Health Premier Plan will cover all medically necessary drugs on the Drug List if: ° your doctor or other prescriber says you need them to get better or stay healthy . and ° you fill the prescription at a Aetna Better Health Premier Plan network pharmacy. • Aetna Better Health Premier Plan may have additional steps to access ...Nov 15, 2023 · The cost of Ozempic (semaglutide) with Medicare varies depending on your specific Medicare plan and coverage. This can range from a modest copayment, such as $10 to $50 per prescription, or a percentage of the medication cost, such as 20% coinsurance. Medicare Part B. These plans often include prescription drug coverage. Plan availability and benefits can vary by location. You can speak with a licensed insurance agent to find Aetna Medicare Advantage plans in your area that cover prescription drugs by calling 1-800-891-6309, TTY: 711. They’re available 24 hours a day, 7 days a week.Semaglutide operates by mimicking the hormone GLP-1, influencing brain areas that regulate appetite. This mechanism leads to a reduction in hunger and, consequently, calorie intake, facilitating significant weight loss. Extensive clinical trials have reinforced the effectiveness of semaglutide, showcasing its potential in achieving …Medicare and Ozempic: Takeaways. As of 2023, Medicare covers Ozempic for the treatment of Type 2 diabetes, but it will not cover the drug specifically for weight loss. A prescription drug, Ozempic will be covered under most Medicare Part D plans. If Ozempic is covered by your Medicare Part D plan, you’ll still be responsible for a copay …Does anyone have experience getting coverage from Aetna? Locked post. New comments cannot be posted. Share Sort by: Best. Open comment sort options Best; Top; New ... We do not permit the discussion of non-FDA approved formulations of semaglutide, nor do we permit selling or offering for sale any medication, including by private message. Do not ...Ozempic (semaglutide) is a prescription medication that is used to control blood sugar in people with type two diabetes. It is injected into the body through a small needle that is housed in a pen-like device that can be transported in a pocket, purse or other small container. This medication is not for use in people with type one diabetes due ...Find a list of covered prescription drugs under your Aetna plan - or for the plan you're considering if not yet a member - as well as medication cost estimates.Covering scars with makeup can help make them disappear. See five secrets to covering scars with makeup to learn the tricks of the trade. Advertisement Few of us are blessed with ...Novo Nordisk, the manufacturer of Ozempic, offers a copay assistance program for individuals with commercial insurance. Eligible patients pay as little as $25 for up to a 3-month supply of Ozempic. This program, however, does not apply to people using government-assisted programs such as Medicare or Medicaid.

Semaglutide is a medication that can help manage blood sugar levels in people with type 2 diabetes. The coverage of Semaglutide under HSA varies depending on your specific plan. It is important to review your HSA plan documents or contact your HSA provider to determine if Semaglutide is covered. Semaglutide offers several benefits for diabetes ...

And yes, these drugs often come with the bonus side effect of weight loss. With most GLP-1 drugs, however, weight loss tends to be modest — most people lose only 6 to 9 pounds. Those who take 2.4 mg of semaglutide (Wegovy) often lose far more. If your starting weight is 200 pounds and the drug enables you to drop 15 percent, you'll lose 30 ...RYBELSUS ® (semaglutide) savings and coverage tools for your patients. Novo Nordisk is here to help you get your patients started on RYBELSUS ®. Use the tools below to find …Aetna Non-Medicare Prescription Drug Plan. Subject: GLP-1 Agonist Ozempic PA with Limit 2439-C 08-2021. Policy: FDA-approved Indications. Ozempic is indicated: as an adjunct …Apr 22, 2024 · Novo Nordisk, the manufacturer of Ozempic, offers a copay assistance program for individuals with commercial insurance. Eligible patients pay as little as $25 for up to a 3-month supply of Ozempic. This program, however, does not apply to people using government-assisted programs such as Medicare or Medicaid. The cost of Ozempic varies based on a number of factors, like dosage and insurance coverage. According to Novo Nordisk, the manufacturer of Ozempic, most people don’t pay the list price for ...Jun 21, 2023 · However, insurance will typically cover the cost of semaglutide only for people who meet certain criteria. These criteria vary by brand, as each is formulated for a different use. Eligibility for ... Pay as little as $25 for Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. Get started. Max savings of $150 for a 1-month, $300 for a 2-month, and $450 for a 3-month supply. Month defined as 28 days, offer good for up to 24 months. For eligible, commercially insured patients whose insurance covers Ozempic®.We make coverage decisions on a case-by-case basis consistent with applicable policies. We review many of the services used by patients. These include tests, treatments, surgeries and hospital stays. We use nationally recognized guidelines to decide whether a service is appropriate and, therefore, covered. If we do not consider the service to ... Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. What Is Ozempic? Conditions That Ozempic Is Approved to Treat. Eligibility Criteria for Ozempic. Who Shouldn’t Take Ozempic? Who Can Prescribe Ozempic? How …

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The cost of Ozempic varies based on a number of factors, like dosage and insurance coverage. According to Novo Nordisk, the manufacturer of Ozempic, most people don’t pay the list price for ...In early June, the U.S. Food and Drug Administration approved semaglutide 2.4 mg (Wegovy) for chronic management of obesity and for those with a body mass index (BMI)* of 27 or greater in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes, or dyslipidemia). 1 Semaglutide is a member of the …Semaglutide is a medication that has shown promising results in managing PCOS symptoms. It is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps regulate blood sugar levels and promotes weight loss. Many women with PCOS are interested in trying Semaglutide as part of their treatment plan, but a common concern is whether …Buy Semaglutide Online: A Comprehensive Guide. Semaglutide is a medication that is used for managing type 2 diabetes and aiding in weight loss. It has shown significant benefits in improving blood sugar control‚ reducing appetite‚ and potentially promoting weight loss. If you are considering buying Semaglutide online‚ there are several ...Novo Nordisk, the manufacturer of Ozempic, offers a copay assistance program for individuals with commercial insurance. Eligible patients pay as little as $25 for up to a 3-month supply of Ozempic. This program, however, does not apply to people using government-assisted programs such as Medicare or Medicaid.Jan 16, 2024 · Summary. Ozempic and other GLP-1 medications are effective weight loss medications that may or may not be covered by Medicare Part D. Because current legislation does not allow Medicare Part D to cover weight loss medications, these drugs will only be covered when they are used to treat diabetes. That could change as professional organizations ... Wegovy (semaglutide), a prescription medication for chronic weight management, has a list price of about $1,350 for a 28-day supply. This means that the medication could cost more than $16,000 per year without insurance or manufacturer discounts. Coverage for weight-loss medications like Wegovy varies widely depending on the kind of insurance ...Usually around $300 a month. Did you ask if they cover any weight loss medication? I guess it just depends on what your employer pays for. I have Aetna through my employer with caremark as the prescrip service and they cover Wegovy for weight loss.Wegovy ® (semaglutide) injection 2.4 mg is indicated in combination with a reduced calorie diet and increased physical activity: to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight. ….

Under it, health plans are required to provide consumers with a document giving them information about health plan benefits and coverage. This is a Summary of Benefits and Coverage (SBC) document. The SBC gives you helpful information about what the plan covers. It also has examples of how much you might pay for certain health events or … Aetna You get a lot of coverage for your buck with renter’s insurance. For example, you might be surprised to learn that most policies cover stuff that’s stolen outside of your home. It’...Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract.Aetna Non-Medicare Prescription Drug Plan. Subject: GLP-1 Agonist Ozempic PA with Limit 2439-C 08-2021. Policy: FDA-approved Indications. Ozempic is indicated: as an adjunct …Are you a recipient of Aetna Medicaid? If so, you may be wondering how to find healthcare providers and specialists within the Aetna Medicaid network. Aetna Medicaid is a managed c...Check your cost and coverage. This assessment is based on the information that you provide and does not constitute a guarantee of coverage or co-pay amount. Call your …Indications and Limitations of Use. Ozempic ® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 …Our analysis also found a lack of transparency about how health plans cover semaglutide, as 7 of the 18 included plans did not issue a public coverage policy for the drug. Non-issuance of a coverage policy does not necessarily mean non-coverage, though it does mean that coverage information is not publically available.Pay as little as $25 for Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. Get started. Max savings of $150 for a 1-month, $300 for a 2-month, and $450 for a 3-month supply. Month defined as 28 days, offer good for up to 24 months. For eligible, commercially insured patients whose insurance covers Ozempic®. Does aetna cover semaglutide, This particular announcement only moderately expands insurance coverage for the drugs, as Aetna has about 6% of Americans on its medical plans, and only an …, Phentermine-Topiramate Extended Release (Qsymia) is the most effective weight loss medication available today. It combines an adrenergic agonist with a neurostabilizer. Daily doses with four strengths start at 3.75/23mg to 15mg/92mg. Adults with migraines and obesity are good candidates for this weight-loss drug., And yes, these drugs often come with the bonus side effect of weight loss. With most GLP-1 drugs, however, weight loss tends to be modest — most people lose only 6 to 9 pounds. Those who take 2.4 mg of semaglutide (Wegovy) often lose far more. If your starting weight is 200 pounds and the drug enables you to drop 15 percent, you'll lose 30 ..., WEGOVY ® (semaglutide) injection 2.4 mg is an injectable prescription medicine used with a reduced calorie diet and increased physical activity: to reduce the risk of major cardiovascular events such as death, heart attack, or stroke in adults with known heart disease and with either obesity or overweight., The CVS Health Tracker app puts Aetna members in charge of their diabetes care. They can pair their glucose meter and/or blood pressure cuff, track and sync readings, and add notes. The app then makes the readings available to the program’s care team. Members can also share readings with their doctor. The app also includes educational content ..., For obesity or weight loss. Brand Name (s): Wegovy. Generic Name: Semaglutide. Instructions. Cautions. Side Effects. Please speak with your doctor, nurse, or pharmacist if you have any questions about this medicine., BPMP Provinsi Gorontalo. Beranda; Profil Menu Toggle. Sejarah; Visi Dan Misi; Tugas Dan Fungsi; Struktur Organisasi; Fasilitas, Find a list of covered prescription drugs under your Aetna plan - or for the plan you're considering if not yet a member - as well as medication cost estimates., does aetna cover semaglutide, Diet Pills That Really Work; But, how to make fasting easy, Golo Diet Pills Amazon. If she did not commit suicide, she might not have the chance to live with Nangong Ruyan is body. But people are biased. Now, Nangong Ruyan is her, and she is Nangong Ruyan. She is naturally obliged to seek justice for herself ..., * Subject to a maximum savings of $225 per 28-day supply (1 box) for up to 13 fills for commercially insured patients with coverage for Wegovy ®. If you pay cash for your prescriptions or your commercial insurance does not cover Wegovy ®, you can save $500 per 28-day supply (1 box) of Wegovy ®. Eligibility and other restrictions apply. Novo ... , Policy/Guideline: If the patient has filled at least 60 days of metformin within the past 180 days under the Aetna Better Health prescription benefit and has a diagnosis of Type 2 Diabetes, then the requested drug will be paid under that prescription benefit. If the patient does not meet the. AETNA BETTER HEALTH®., The phase III study showed that semaglutide significantly reduced the composite of cardiovascular death, heart attack, and stroke by 20% (HR 0.80, 95% CI 0.72-0.90)., Aetna Better Health Premier Plan will cover all medically necessary drugs on the Drug List if: ° your doctor or other prescriber says you need them to get better or stay healthy . and ° you fill the prescription at a Aetna Better Health Premier Plan network pharmacy. • Aetna Better Health Premier Plan may have additional steps to access ..., Our analysis also found a lack of transparency about how health plans cover semaglutide, as 7 of the 18 included plans did not issue a public coverage policy for the drug. Non-issuance of a coverage policy does not necessarily mean non-coverage, though it does mean that coverage information is not publically available., Wegovy is a brand-name medication approved by the Food and Drug Administration (FDA) for weight loss in certain patients, including children 12 and older. It should be used together with a reduced-calorie diet and increased physical activity. Depending on your specific insurance plan, Blue Cross Blue Shield (BCBS) may cover …, RYBELSUS ® (semaglutide) savings and coverage tools for your patients. Novo Nordisk is here to help you get your patients started on RYBELSUS ®. Use the tools below to find …, Pay as little as $25 for Ozempic® (semaglutide) injection 0.5 mg, 1 mg, or 2 mg. Get started. Max savings of $150 for a 1-month, $300 for a 2-month, and $450 for a 3-month supply. Month defined as 28 days, offer good for up to 24 months. For eligible, commercially insured patients whose insurance covers Ozempic®., Policy/Guideline: If the patient has filled at least 60 days of metformin within the past 180 days under the Aetna Better Health prescription benefit and has a diagnosis of Type 2 Diabetes, then the requested drug will be paid under that prescription benefit. If the patient does not meet the. AETNA BETTER HEALTH®., If Ozempic was a weight loss drug you would have a good shot, being a diabetes drug you may be denied unless you have a history of type 2 and have already tried metformin. It takes a few weeks. And your doctor may have to file more than one appeal. Last year, my first year, it took about a month., Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract., This is an unofficial community for people who use or are interested in Wegovy, or other GLP-1 RA medications, for weightloss. Wegovy is a once-weekly injection of semaglutide, which is a medication that mimics glucagon-like-peptide (GLP-1) in the body. GLP-1 is a key regulator of weight and blood sugar., Tesofensine is a medication that was developed to treat obesity by increasing the likelihood of weight loss. It is a small molecule compound that works as a “triple reuptake inhibitor.”. This means it works by blocking the body’s absorption of the three main neurotransmitters associated with “reward.”., Jan 16, 2024 · Summary. Ozempic and other GLP-1 medications are effective weight loss medications that may or may not be covered by Medicare Part D. Because current legislation does not allow Medicare Part D to cover weight loss medications, these drugs will only be covered when they are used to treat diabetes. That could change as professional organizations ... , How does semaglutide help with weight loss? What does semaglutide do? Semaglutide belongs to a class of drugs called GLP-1 receptor agonists or glucagon-like peptide 1 receptor agonists. Increases insulin secretion, which is good for diabetes. But in higher doses it acts on the centers of the brain and suppresses the appetite., This is an unofficial community for people who use or are interested in Wegovy, or other GLP-1 RA medications, for weightloss. Wegovy is a once-weekly injection of semaglutide, which is a medication that mimics glucagon-like-peptide (GLP-1) in the body. GLP-1 is a key regulator of weight and blood sugar. , Summary. Retail Prescriptions (up to 30-day supply) - Generic drug: $15; Preferred brand-name drug: $40, plus the cost difference between the brand and the generic, if one exists.; Non-preferred brand-name drug: $80, plus the cost difference between the brand and the generic, if one exists. Retail Maintainence at CVS Pharmacy and Mail Order ..., A one-month supply of Ozempic (2 milligrams, the highest dosage) currently retails for $935.77 on the Novo Nordisk website, and prices range between approximately $900 and $1,100 on GoodRx. Novo ..., Dr. Russo and Dr. Shah expect a newly FDA-approved tirzepatide weight loss medication, Zepbound, to be covered in about a year. (It often takes a few months to a year before insurance companies ..., And yes, these drugs often come with the bonus side effect of weight loss. With most GLP-1 drugs, however, weight loss tends to be modest — most people lose only 6 to 9 pounds. Those who take 2.4 mg of semaglutide (Wegovy) often lose far more. If your starting weight is 200 pounds and the drug enables you to drop 15 percent, you'll lose 30 ..., Usually around $300 a month. Did you ask if they cover any weight loss medication? I guess it just depends on what your employer pays for. I have Aetna through my employer with caremark as the prescrip service and they cover Wegovy for weight loss., Just six years later, in 2023, approximately 1 in 60 Americans was prescribed a semaglutide medication. Market analysts predict that sales of these drugs, which have a list price of up to $1,350 per month, could reach $100 billion by 2030. Some even say they could become the most prescribed drugs ever. ... Medicare does cover Ozempic — just ..., Although Medicare does cover quite a bit of durable medical equipment, dental care is something that Medicare generally neglects to provide coverage for regardless of your dental c..., Medicare covers Ozempic for Type 2 diabetes. Medicare prescription drug plans might cover Ozempic, but only to treat diabetes. In 2021, Medicare covered Ozempic for about 459,000 Medicare ...