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After insurance for New York City employees began covering GLP-1 weight-loss injectables at the beginning of the year, nearly 1,000 city workers and their dependents began using the drugs.
And now they’re being told that coverage was accidental and they need to stop.
In a statement to Gothamist, a city spokesperson admitted that municipal employee insurance coverage for these fullness-mimicking medicines was made “in error.”
“The city never planned to cover these drugs,” spokesperson Liz Garcia told the website, “due to the steep costs that would fall on city employees.”
While those who take GLP-1s for diabetes will continue to have their medication covered by municipal insurer EmblemHealth, those who use them strictly for weight loss will be left out in the cold.
For longtime NYC Department of Education employee Sarah Kalemkerian, that means her Zepbound prescription will go from costing $25 every three months to $550 per month — a price increase she can’t afford on her own.
Kalemkerian told Gothamist that she’d tried every fad diet before getting insurance coverage for Zepbound. After years of crash dieting, the DOE lifer started the injectable in January and was thrilled when she rapidly shed 30 pounds.
“It changed my life,” Kalemkerian said.
In a letter Gothamist reviewed, NYC employees were informed that the city would stop covering Zepbound and Wegovy, the sister drug to Novo Nordisk’s diabetes injectable Ozempic, in January. Employees already taking the drugs will be briefly grandfathered in until either June 2025 or the expiration of their prescription authorization, whichever comes first.
Though Kalemkarian didn’t say what her next move will be after that discontinuation, another city employee told Gothamist that he’s considering taking a compounded version of his brand-name prescription to save money.
“Once you get on this medication, you don’t want to stop because the results are so good,” explained Michael Ragusa, a Correctional Health Services employee who got Zepbound through his city insurance.
Unlike the expensive brand-name drugs, compounded versions of tirzepetide (the active ingredient in Zepbound) and other GLP-1s are generally frowned upon by doctors because the pharmacies that make them are regulated only on the state level and have no federal oversight.
Still, Ragusa and others facing the loss of coverage for their GLP-1s have been forced between a rock and a hard place by insurers — and clearly, the promise of keeping off the weight is winning out.
More on GLP-1s: The Diet Industry Is Reportedly in Total Meltdown Over GLP-1 Weight Loss Drugs
