Zepbound coverage for Sleep Apnea gets Agency approval
Center for Medicare and Medicaid declared that Zepbound is covered by insurance for treating Sleep Apnea, given it's effectiveness.
In an interview with CNBC, the Centers for Medicare and Medicaid have declared that Zepbound (Tirzepatide) can now be covered by medicare drug plans:
Annika Kim Constantino
In a statement to CNBC, a spokesperson for the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services, said "current Medicare Part D and Medicaid coverage rules apply" to Zepbound following its landmark approval in December for the most common sleep-related breathing disorder.
What is Mounjaro/Zepbound (Tirzepatide)? How does it differ from Ozempic (Semaglutide)?
Tirzepatide is a GLP1 Receptor Agonist that was created by Eli Lilly, a pharmaceutical corporation.
Check out our quick explainer
What's unique about Tirzepatide is that it is a dual agonist, both a GIP and GLP1 receptor agonist. While this doesn't translate exactly to being "twice as effective" Tirzepatide has been shown to be more effective than Semaglutide alone:
GLP1.Guide Staff
There have also been other benefits, in particular kidney disease improvements for people taking Tirzepatide:
GLP1.Guide Staff
Currently, Mounjaro/Zepbound are some of the most popular and effective GLP1 drugs on the market.
Zepbound (Tirzepatide) FDA approval for Sleep Apnea
Tirzepatide got approved by the FDA for treating Sleep Apnea in 2024 – right at the end of the year.
Office of the Commissioner
This was a first – no other drug had been approved to treat sleep apnea, and now a seemingly unrelated (yet incredibly effective) drug rocketed to approval. Of course, "rocketed" isn't the right term because GLP1 Receptor Agonists like Tirzepatide have been under scrutiny and have been actively researched for over a decade now.
The use cases for GLP1 Receptor agonists continues to grow, and Tirzepatide is often cited – Mounjaro is still currently the only FDA GLP1 Receptor Agojnist approved for "chronic weight management" (weight loss).
The discovery of potential for Sleep Apnea treatment in Zepbound
How did we know that Zepbound might be able to treat Sleep Apnea? Well, we have the SURMOUNT-OSA trial to thank:
Atul Malhotra
This trial found that Zepbound was effective in treating Tirzepatide, reducing apnea events by half on average. This means that sufferers of sleep apnea would have dramatically reduced suffering and a lower likelihood of adverse effects.
On top of essentially halving the number of apnea events per hour, there were significant improvements in other endpoints, and the usual benefits that come with GLP1 Receptor Agonists (normally BMI, HBa1c, etc).
This research was a large indicator in the effectiveness of Tirzepatide on Sleep Apnea, and a key factor in the decision of the FDA and Centers for Medicare and Medicaid. The research supports the safe use of Tirzepatide for Sleep Apnea sufferers.
How many people suffer from Sleep Apnea?
While there is not much current extensive surveying of the issue, Sleep Apnea is a widely experienced condition, spanning countries and geographies.
Research from 2020 suggests that close to 1.5 Billion people may suffer from it globally:
Reliable prevalence data for obstructive sleep apnoea were available for 16 countries, from 17 studies. Using AASM 2012 diagnostic criteria and AHI threshold values of five or more events per h and 15 or more events per h, we estimated that 936 million (95% CI 903–970) adults aged 30–69 years (men and women) have mild to severe obstructive sleep apnoea and 425 million (399–450) adults aged 30–69 years have moderate to severe obstructive sleep apnoea globally. The number of affected individuals was highest in China, followed by the USA, Brazil, and India.
This is clearly a large amount of people with Sleep Apnea and more importantly it's a huge impetus for insurance companies to cover Mounjaro/Zepbound – yet another malady that is cured by these incredibly effective medications.
