UAE residents who may qualify for newly approved oral obesity pills such as Foundayo (orforglipron) and Wegovy — which are expected to enter the market soon — may face a question: will my insurance pay for it?
Industry experts said that the answer is not clear yet.
While Foundayo has been approved by the Emirates Drug Establishment (EDE), insurance experts said regulatory approval does not mean a medicine is added to insurance coverage. Decisions on whether the treatment will be covered and under what conditions, are expected to be assessed.
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Is the new obesity pill covered right now?
Experts said there is no confirmation yet that the newly approved oral treatment is covered under UAE insurance plans.
According to Toshita Chauhan, CBO, Policybazaar, coverage for obesity medications in the UAE remains limited and often depends on why the drug is prescribed.
“Some GLP-1 drugs may be covered when used for type 2 diabetes, but coverage often changes when the same medicines are prescribed for weight management,” she said.
Anas Mistareehi, CEO of eSanad, said: “Newly approved treatments are not automatically included in insurance coverage and typically go through additional layers of review.”
Will basic insurance plans cover it?
Experts said that is unlikely, at least under current structures. Basic or mandatory health plans are generally designed around essential healthcare benefits, and obesity medications have often fallen outside that scope.
“Obesity treatment has often been treated as a lifestyle issue rather than a standard insured medical benefit,” said Chauhan.
Mistareehi said: “Most basic plans do not typically include weight-loss medications.”
That means many patients may still need to pay out of pocket, at least initially.
What about premium plans?
Coverage may be possible in some cases, but it may vary significantly.
Experts said higher-tier plans may consider obesity-related drugs where there is documented medical necessity, especially when linked to conditions such as diabetes, hypertension or cardiovascular risks. But there are no guarantees.
Chauhan said that the individual policy’s drug formulary, the list of approved medications under a plan, may play a major role.
“Two people on different premium plans, with identical BMIs and identical prescriptions, can end up with completely different outcomes at the pharmacy counter,” she said.
How do insurers decide whether to cover a new drug?
Experts said the process is usually gradual.
After regulatory approval, insurers may assess:
“Any expansion of coverage is likely to be controlled and data-driven, rather than immediate,” said Mistareehi.
When will a decision be made?
There is no fixed timeline yet.
Experts said that the coverage decisions could take time and may not happen uniformly across the market, meaning some insurers could move earlier than others, while others may take longer or apply stricter conditions.
That is why experts said coverage for the new obesity pill is yet to be determined.
Could coverage evolve later?
Possibly, yes.
“The UAE insurance market is at a critical inflection point, with obesity increasingly being recognised as a chronic medical condition with long-term health implications, rather than purely a lifestyle issue,” said Mistareehi.
Experts also said that the shift could influence coverage decisions over time, particularly if newer treatments are seen to reduce complications linked to diabetes, heart disease and other chronic illnesses.
But for now, they believe the picture remains fluid.
For patients, the next big question after eligibility may not be whether they can be prescribed the pill, but whether their insurance will help pay for it.
Source: Khaleej Times