Last updated: June 2024

There is a worldwide shortage of injectable medications used to treat Type 2 diabetes and to manage obesity and extra weight.

We know this shortage is frustrating, and we are here to support you.

We are making adjustments as we navigate the shortage. We strive to help you know what to expect during this time. Thank you for your understanding and cooperation.

Insurance Coverage

You must determine if your health plan covers a medication. If they do not, we can give you a letter asking your insurance/employer to cover it for you. However, we cannot submit individual appeals.

Health plans often change their coverage of these medications.

Prepare for these things to happen without much notice:

• Costs your health plan does not pay for, called out-of-pocket costs
• Changes to what your health plan covers

Prior Authorization

For your health plan to cover a prescription, they may require that they approve the prescription before you fill it. This is called prior authorization.

Health plans typically require prior authorization for:

• The starting dose of these injectable medications
• Each change in dose afterward

We try to find the lowest dose that you benefit from. Our goal is to keep using that dose for as long as it works.

However, insurance often requires us to increase the dose according to their preferred schedule. This may cause side effects. Unfortunately, at this time, we cannot ask your health plan to keep using a specific dose.

You may be without your medication for an extended period of time due to medication shortages. Your insurance plan may not allow you to start titration over again. Titration is the process of finding the medication dose that works best for you. We are finding insurance companies are frequently denying these requests.

Processing Prior Authorization Requests

We process all prior authorization requests:

• As quickly as possible
• In the order we receive them

After we submit a prior authorization request to your health plan, contact them for updates. The time it takes a health plan to process a request varies. We have found health plans can take 10 to 14 days to process a request. Sometimes it takes longer.

What to Expect When Filling Your Prescription

Prepare for delays and having a hard time filling your prescription. You may need to call multiple pharmacies to find ones that can fill your prescription.

• We cannot contact pharmacies for you.
• We do not have up-to-date information about which pharmacies can fill your prescription.

After we write the prescription to your preferred pharmacy, you are responsible for:

• Finding a pharmacy with available medications
• Transferring the prescription to other pharmacies when needed

If you do not have diabetes, it is not harmful to stop taking your prescribed medication.

We do not recommend trying to start tirzepatide (Zepbound® or Mounjaro®) at this time due to the supply shortage.

• Wegovy® is an alternative for managing obesity or extra weight.
• Ozempic is an alternative for managing Type 2 diabetes.

Depending on the shortage, our clinicians will use their professional judgment to decide if you can start one of these medications at your visit. We cannot promise your health plan will cover it or that it will be available.

Communication

Because of the shortage, we are getting many medication-related messages in MyNM, our patient portal.

• We will respond to MyNM messages within two business days.
• We only review messages during business hours.
• Please wait the full two business days before you send a follow-up message.
• Do not use MyNM for urgent or emergency requests. If it is an emergency, call 911.

If you need care quickly, but your condition is not life-threatening:

• Go to a Northwestern Medicine Immediate Care Center in person.
• Call your medical professional’s office.