Glossary entry
Prior authorization (PA)
Definition
An insurance company's requirement to approve a prescription before covering it. Most insurance plans require PA for Wegovy and Zepbound, often with documentation of BMI ≥30 and prior lifestyle-intervention attempts.
Related terms
A1C (HbA1c)
A blood test that measures average blood glucose over the past 2-3 months. A1C ≥6.5% indicates diabetes. GLP-1 medications typically lower A1C by 1-2 percentage points.
BMI (Body Mass Index)
A screening calculation of body weight relative to height (kg/m²). FDA-approved weight-management GLP-1s require BMI ≥30, or ≥27 with a weight-related comorbidity.
Bioavailability
The proportion of a drug that reaches systemic circulation in active form. Injectable GLP-1s (Wegovy, Mounjaro) have higher bioavailability than oral semaglutide (Rybelsus).
Compounded medication
A medication custom-prepared by a licensed compounding pharmacy, often using the same active ingredient as a brand-name drug. The FDA allowed compounded semaglutide during the 2022-2025 shortage; access has tightened since.
Comorbidity
A second medical condition occurring with the primary one. Hypertension, type 2 diabetes, dyslipidemia, and obstructive sleep apnea are common weight-related comorbidities that lower the BMI threshold for GLP-1 eligibility to 27.
Contraindication
A specific situation in which a drug should not be used. GLP-1 contraindications include personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).