The drugs included on standard panels are controlled substances and high-abuse-potential medications
"Not medically necessary" or "step therapy required" = PA denial (you can appeal) "Excluded benefit" or "not covered" = plan exclusion (different strategy needed) WHAT'S COMING Aetna Coverage Outlook for 2026 Update: Zepbound Returns to Aetna Formularies October 1, 2026 On May 28, 2026, CVS Caremark (Aetna's PBM) announced it is adding Zepbound back to its commercial formularies as an "additional preferred option," effective October 1, 2026 (Wegovy keeps its preferred status)
And, some people think that it's just the medication, but really you do have to have an active lifestyle and then also be very good at what you're eating.
Does semaglutide have to be prescribed
Who should avoid taking GLP-1 medications
The introduction of an oral version could improve patient adherence, provide a more convenient treatment option, and shape the future of metabolic disease management