diethylpropion — Cigna

Weight Loss

Initial criteria

Patient is age ≥ 16 years; AND
Patient has engaged in a trial of behavioral modification and dietary restriction for at least 3 months; AND
Patient meets ONE of the following (a or b): a) At baseline, patient had a body mass index (BMI) ≥ 30 kg/m2; OR b) Patient meets BOTH of the following [(1) and (2)]: (1) At baseline, patient had a BMI ≥ 27 kg/m2; AND (2) At baseline or currently, patient has at least ONE of the following weight-related comorbidities: hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cardiovascular disease, knee osteoarthritis, asthma, chronic obstructive pulmonary disease, metabolic-dysfunction associated steatotic liver disease/non-alcoholic fatty liver disease, polycystic ovarian syndrome, or coronary artery disease; AND
The medication will be used concomitantly with behavioral modification and a reduced-calorie diet.

Patient is age ≥ 16 years; AND
Patient meets ONE of the following (a or b): a) At baseline, patient had a BMI ≥ 30 kg/m2; OR b) Patient meets BOTH of the following [(1) and (2)]: (1) At baseline, patient had a BMI ≥ 27 kg/m2; AND (2) At baseline or currently, patient has at least ONE of the following weight-related comorbidities: hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cardiovascular disease, knee osteoarthritis, asthma, chronic obstructive pulmonary disease, metabolic-dysfunction associated steatotic liver disease/non-alcoholic fatty liver disease, polycystic ovarian syndrome, or coronary artery disease; AND
Patient has lost ≥ 5% of baseline body weight; AND
The medication will be used concomitantly with behavioral modification and a reduced-calorie diet.

initial 3 months; reauth 1 year