Ro, a direct-to-consumer health-care startup, has launched a new free tool to help patients determine whether their insurance covers GLP-1s, a class of weight loss and diabetes drugs. While most insurance plans cover GLP-1s for diabetes treatment, coverage for weight loss treatments is less widespread. This can make it challenging for patients to navigate the complex insurance landscape and for doctors to prescribe the medications efficiently.
According to Ro, nearly half of the company’s patients have some form of insurance coverage for a GLP-1. However, some patients may be missing out on treatment simply because they are unaware of their coverage options. Ro’s new tool aims to help patients understand their coverage so they can make informed decisions about pursuing weight loss treatment.
The demand for GLP-1s, such as Novo Nordisk’s Wegovy and Ozempic, has surged in the U.S. over the past year. As a result, other drugmakers and digital health companies like Ro are looking to capitalize on the growing market, which analysts predict could be worth over $100 billion by the end of the decade.
Ro’s program allows patients to be prescribed a GLP-1 and offers compounded versions of the medication when branded versions are in short supply. Compounded GLP-1s are custom-made alternatives designed to meet a specific patient’s needs. Additionally, patients in the program have access to monthly doctor consultations, educational resources for weight management, 24/7 messaging, one-on-one coaching with nurses, and assistance with navigating insurance coverage.
The insurance tool provided by Ro is available online and requires patients to input basic medical and insurance information. Within one to three days, patients receive a personalized report detailing their coverage, whether prior authorization is required, and the estimated copay for each major GLP-1 medication. The information in the report comes directly from insurers and includes next steps for the patient, such as joining Ro’s GLP-1 program or sharing the findings with their doctor.
By providing patients with early access to information about their coverage options, Ro aims to streamline the patient journey and empower individuals to make informed decisions about their health. The tool’s sample report outlines insurance coverage, supply availability, estimated copays, and potential out-of-pocket costs for medications like Wegovy, Ozempic, Zepbound, and compounded semaglutide.
Overall, Ro’s insurance tool is designed to be the first step for individuals interested in GLP-1s, offering valuable insights that can influence their treatment path. Whether patients choose to pursue treatment through Ro or their in-person doctor, understanding their coverage options is essential for making informed decisions about their health.