Wegovy (semaglutide) — Point32Health
Secondary cardiovascular prevention in overweight or obesity
Initial criteria
- Patient age ≥ 45 years
- Established cardiovascular disease as evidenced by prior myocardial infarction, prior stroke, or peripheral arterial disease
- BMI ≥ 27
- Used as adjunct to lifestyle modification (dietary restriction, exercise, behavioral support, community-based program)
- Patient on standard-of-care therapy from each of the following unless contraindicated or intolerant: cholesterol-lowering medication (e.g., statin), antihypertensive (e.g., ACE inhibitor, ARB, beta blocker), and antiplatelet agent (e.g., aspirin, clopidogrel)
- No diagnosis of type 1 or type 2 diabetes
- No NYHA class IV heart failure
Reauthorization criteria
- Member adherent to therapy with consistent fills over past 4 months
- Currently on a maintenance dose of 1.7 mg or 2.4 mg once weekly
- Established cardiovascular disease as evidenced by prior myocardial infarction, prior stroke, or peripheral arterial disease
- Used as adjunct to lifestyle modification (dietary restriction, exercise, behavioral support, community-based program)
- Continues on standard-of-care therapy from each of the following unless contraindicated or intolerant: cholesterol-lowering medication, antihypertensive, and antiplatelet agent
- No diagnosis of type 1 or type 2 diabetes
- No NYHA class IV heart failure