The medicine did its job. She lost the weight. And according to her lawsuit, that's exactly why her insurer stopped paying for it. You're listening to GLP-1 Daily, and it's Thursday, October 22. That lawsuit leads the show. After it, telehealth companies prescribing GLP-1s for addiction ahead of any FDA approval, and a closer look at what a big trial actually found about oral semaglutide and the kidneys.
From MyNewsLA, quoting a lawsuit against Anthem Blue Cross:
“Despite this knowledge, Anthem intentionally and wrongfully refused Zepbound for Alicia simply because the drug began to work for her and lowered her weight to where she was no longer morbidly obese,” according to the suit.
Here's the backstory, from her complaint. In 2022, Alicia Butterfield's plan at the time, Blue Shield, approved Mounjaro. Her BMI was over forty, and she had prediabetes and high blood pressure. In February 2025 she switched to an Anthem HMO. The suit says Anthem refused Mounjaro because she didn't have diabetes and suggested her doctors request Zepbound. Then in April it denied Zepbound too, saying her plan only covers morbid obesity. What happened this week is procedural. On Monday, Los Angeles Superior Court Judge Colin Leis granted Anthem's motion to send the case to an arbitrator instead of a jury. He also paused the lawsuit until arbitration is done, and set a status conference for April 19, 2027. Her lawyers argued Anthem skipped arbitration disclosures that California law requires. The judge said that rule covers plans regulated by a state department, not Covered California, which is where she bought her plan. So the fine print on where you shop for insurance decided where this case gets heard. Caveats. Everything about the denial so far comes from her complaint. No one has ruled that Anthem broke its contract, and arbitration usually happens out of public view. The suit alleges her condition has worsened since the denial. That's her claim, not a finding. The structural problem is still there, though. A threshold that only checks today's weight punishes anyone the drug helped. On October 8 we covered a Health Affairs analysis that raised a similar gap in Medicare's Bridge: the form doesn't say how to document a starting BMI. If you're on a GLP-1 for weight, ask your insurer in writing what it takes to keep coverage once you've lost weight. And ask your prescriber to make sure your chart records your starting weight and conditions.
STAT, in a report out this morning:
But some telehealth platforms that specialize in treating addiction aren’t waiting. In the last year, a few companies have begun to market off-label prescriptions of GLP-1s, both branded and compounded, to treat alcohol use disorder and other addictions.
Aren't waiting for what? The research. STAT lists the programs underway. Lilly is testing a new drug, brenipatide, in alcohol use disorder. A new company, Baseline Therapeutics, is studying a GLP-1 drug in alcohol, cocaine and methamphetamine use disorders. Altimmune is testing pemvidutide for alcohol. And specialists are hopeful the FDA may soon approve a new alcohol use disorder medication, which would be the first in two decades. That's the backdrop. None of those trials is a GLP-1 approved for addiction today. Prescribing off-label is something doctors are allowed to do. Marketing it as a service is a different posture. I get why people want it. Addiction treatment options are thin, and these companies are selling hope to people who've run out of patience. But branded or compounded is my first question. With compounded, you're also trusting whoever made the vial. If this is something you're considering, take it to a prescriber who knows your whole history. Ask what evidence they're relying on for this use, who's monitoring you, and whether the product is an FDA-approved brand or compounded.
The PeptideMethods editorial team, reviewing kidney results from the SOUL trial:
The kidney signal in SOUL was a change in an eGFR measure, not evidence that oral semaglutide prevented kidney failure or reduced the need for dialysis.
A quick translation: eGFR is the blood-test estimate of how well your kidneys filter. SOUL randomized 9,650 adults with type 2 diabetes plus heart disease, kidney disease or both, to daily oral semaglutide up to fourteen milligrams or placebo. Follow-up averaged almost four years. The kidney results are published in Diabetes Care, and a letter in that journal's November issue revisits them. Neither prespecified composite outcome was significantly reduced. The hazard ratios were 0.91 and 0.86, and both confidence intervals included no difference. The positive finding was slope: eGFR declined about 0.4 units a year more slowly on the drug. So the lab number moved, but the trial didn't show fewer people reaching kidney failure. And most participants started with fairly healthy kidneys. Mean eGFR was about seventy-four, and only twenty-nine percent began below sixty. Funding: Novo Nordisk paid for SOUL, kept the database and ran the analyses. That doesn't erase a randomized result, but it's why the prespecified endpoints matter. Serious adverse events were slightly less common on the drug, about forty-eight percent versus fifty. The trial didn't measure urine albumin, either. If you have diabetes and you're worried about your kidneys, this is useful context to bring to your prescriber. It's not proof the pill protects your kidneys.
Got a denial letter, a coverage rule or a study you'd like us to dig into? Send it to glp1daily at lantern podcasts dot com. Listener tips shape what we chase.
Links to MyNewsLA, STAT and the SOUL review are in the episode notes. We'll be back tomorrow, Friday, to close out the week. GLP-1 Daily comes to you from Lantern Podcasts.