Saxenda® (liraglutide)

Saxenda (liraglutide) is covered for chronic weight management as an adjunct to diet and increased physical activity in adults with BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with at least one weight‑related comorbidity, and in pediatric patients aged 12–17 meeting obesity criteria (≥95th percentile; FDA pediatric dosing also requires body weight >60 kg); patients not meeting age/BMI criteria or lacking a documented baseline BMI prior to any GLP‑1/GLP‑1‑GIP therapy are excluded. Coverage requires documentation of baseline BMI before any GLP‑1/GLP‑1‑GIP use, a ≥3‑month trial of behavioral/dietary modification, ongoing concomitant behavioral therapy, initial approval for 4 months (renewals 12 months), and reauthorization evidence of ≥4% baseline weight loss for adults (≥1% BMI reduction for pediatrics) plus tolerance of maintenance dose (3 mg daily for adults; 2.4–3 mg daily for pediatrics).

"Adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese)."