Question 1

Is Mounjaro still on shortage?

Accepted Answer

FDA officially declared the tirzepatide shortage RESOLVED in October 2024. This triggered the 503A compounding wind-down — compounded tirzepatide must cease within 60 days of FDA shortage resolution declaration. Regional supply intermittency persists at some doses (5mg, 7.5mg are most common gaps). If your pharmacy is out, check: another local pharmacy, LillyDirect cash-pay ($549/month maintenance), telehealth compounders before their wind-down deadline. Brand Mounjaro is the most reliable supply path post-shortage.

Question 2

How does the Zepbound OSA-with-obesity pathway work?

Accepted Answer

December 2024 FDA approval expanded Zepbound's label к include OSA (obstructive sleep apnea) с obesity. This created a critical insurance pathway: many plans don't cover weight-loss-only GLP-1s but DO cover OSA treatment. PA criteria: documented OSA diagnosis (sleep study с AHI ≥15) plus BMI ≥30. SURMOUNT-OSA trial showed 50% reduction в AHI at 52 weeks. Insurance approval rate for OSA-with-obesity Zepbound is significantly higher than weight-loss Zepbound. If you snore: get a sleep study before any PA submission. If AHI ≥15: this is the cleanest path к Zepbound coverage.

Question 3

Can I use Wegovy after bariatric surgery?

Accepted Answer

Bariatric surgery (gastric bypass, sleeve gastrectomy) delivers initial 25-35% weight loss, but 20-30% of patients experience clinically significant regain by years 5-10. Wegovy is increasingly used as a maintenance tool post-bariatric. Coordination essential: (1) Start no earlier than 6 months post-surgery (allow stomach healing). (2) Lower starting dose typical (0.25mg standard but may extend titration). (3) Closer nutritional monitoring — surgery patients are already on protein/vitamin supplements. (4) Insurance: weight regain after bariatric surgery is increasingly recognized as PA-eligible indication. The combination preserves long-term weight loss better than either alone.

Does Medicare cover Zepbound?

How Medicare handles GLP-1s

What Medicare requires for Zepbound

Cash-pay route

Does Medicare cover Zepbound?

How Medicare handles GLP-1s

What Medicare requires for Zepbound

Cash-pay route