Anyone on Medicare been prescribed Zepbound for sleep apnea

@bp486

How many events per hour were you having?

I am still using my Cpap even though I have a high number of leaks with my nasal cushions due to moving around in my sleep, I still only have 1 event per hr.

Commercial insurance allows coupons usage. Medicare does not. It’s the “Anti kick back “ regulation. Unless your Medicare part D
Covers it. Medicare part d only covers it if the honor the pre auth from the drs

Yes, prescribed Zepbound for both sleep apnea (53 episodes per hr) and obesity. Have lost 34 lbs in 12 wks..

If you are struggling with the cost of zepbound, don't want to go to the internet or a compounding pharmacy (which I certainly didn't -- who knows what you would actually be getting?), you can't go to the vial-and-needle solution (my doctor refused to prescribe this, because the supply chain is questionable for this product and he's part of a system that won't allow it) (also, vial-and-needle is more challenging for us as patients to use), and it's not on your Medicare Part D plan, here's the solution I found.

Go with Ozempic, not Zepbound. If you are paying for the drug yourself, it doesn't matter if the FDA has only approved Zepbound for sleep apnea -- if your doctor is willing to prescribe it off-label, this is an option. Doctors prescribe drugs off-label all the time.

First, you can buy Ozempic at half the retail price either from the manufacturer directly (https://www.novocare.com/pharmacy.html), or from any Costco pharmacy (yes, you need to be a Costco member, but membership is a lot cheaper than one month of Zepbound). This takes it down from roughly $1K/month to half that.

Second, Ozempic is a multi-pen, and each size costs the same. (Zepbound only comes in a single dose pen.) This means you can use click-counting or microdosing (google the terms, or check out https://www.canamericaplus.com/blog/ozempic-dosing-using-clicks-a-guide-to-personalized-dosage) to get the same dose from a larger pen using Ozempic. This means, for example, that you can buy a 2 mg/ml pen and make it last longer than two 1 mg/ml pens, which cuts the price even further. The manufacturer does not recommend this, because they say that they cannot guarantee the amount that will come out of the pen if you dose it in between the levels specified on the pen, which, of course, they can't. However, liguratide uses what appears to be the same pen, and see this study: https://pmc.ncbi.nlm.nih.gov/articles/PMC3262738/.

Ozempic (like all these injectable drugs) needs to be refrigerated until its first use. (This is one reason to be careful of buying from random sources -- if the cold chain is broken at some point during shipping and storage, the product can degrade.) The manufacturer says that after first use, it can then be kept at room temperature until it expires, which is 56 days later. (I keep it in the refrigerator anyway, just in case.) I calculate 56 days of doses and buy a pen that will last that long. I suspect that this is conservative and that especially if you keep it refrigerated and look each time for particles and color changes (signs of degradation), you might be able to get it to last longer, but this is something I've decided not to push.

So to sum up (sorry for such a long post), you can cut the price to maybe a quarter if you use Ozempic rather than Zepbound, while still buying exactly the pen manufactured and sold by Novo Nordisk. All of this assumes your doctor will prescribe it off label for sleep apnea.