2 0 2 6 C O M P E N D I U M O F F E D E R A L M E D I C I N E 8 9 Prime Remote Overseas and TRICARE Young Adult- Prime, including: • US Family Health Plan • TRICARE Prime Remote • TRICARE Prime Overseas • TRICARE Prime Remote Overseas • TRICARE Young Adult-Prime • TRICARE Select plans, including: • TRICARE Select Overseas • TRICARE Reserve Select • TRICARE Retired Reserve • TRICARE Young Adult-Select • Continued Health Care Benefit Program The medications must be considered medically necessary, i.e, appropriate, reasonable and adequate for the patient’s condition and appropriate for that person’s treatment. Prior authorization requirements remain in effect. TRICARE still covers certain drugs—including Ozempic, Mounjaro, Trulicity and Victoza—for all patients to treat diabetes when medically necessary and with prior authorization requirements. Copayments and cost-shares for those drugs haven’t changed. 1Corrado RL, Meier M, Banaag A, Neuman T, et. Al. Prevalence of Obe- sity Medications in the Military Health System: An Update from 2022, Military Medicine, 2026;, usag142, https://doi.org/10.1093/milmed/usag142 2Ukhanova M, Wozny JS, Truong CN, Ghosh L, Krause TM. Trends in glucagon-like peptide 1 receptor agonist prescribing patterns. Am J Manag Care. 2025 Aug 1;31(8):e228-e234. doi: 10.37765/ajmc.2025.89778. PMID: 40829097. 3Emmerich SD, Mabila SL, Stierman B, Ogden CL. Trends in the preva- lence of obesity among U.S. active component service members and civilians, 2013-2023. MSMR. 2026 Feb 4;32(12):17-24. PMID: 41687052; PMCID: PMC12965756. significantly improves cardiometabolic risk factors associ- ated with obesity and leads to health benefits, the investi- gators pointed out. Compared to first-generation obesity medications, sec- ond-generation obesity medications, such as semaglutide 2. 4 mg and tirzepatide, are associated with more weight loss and greater health improvements, but there are sig- nificant barriers to access, including high cost and limited insurance coverage. Also, some patients aren’t appropri- ate candidates for second-generation medications or don’t require the magnitude of weight loss achieved with these agents. Many patients also require more than one obesity medication, so it’s important for clinicians to be knowledgeable about all the obesity medications avail- able for treatment, including first-generation medications, which have many benefits, the authors explained. This review found that first-generation obesity medica- tions continued to play an important role in clinical prac- tice, and in appropriately selected patients, these medica- tions can be highly effective. With first-generation obesity medications, mean weight loss is less than newer incretin- based therapies, but trial data demonstrate that a sub- stantial proportion of individuals on first-generation agents achieve 10% or more total body weight loss. The study authors suggested that first-generation obe- sity medications are a cost-effective, evidence-based component of comprehensive obesity care. They are also critical tools for addressing atherosclerosis and other car- diometabolic complications of obesity. Newer guidelines increasingly support ear- lier use of pharmacotherapy alongside life- style modification, a pivot from earlier recommendations. Obesity pharmacotherapy still remains underutilized, even though the American Diabetes Association Standards of Care now identify weight man- agement as a primary goal of treatment in patients with Type 2 diabetes who are overweight or obese, however. Obesity pharmacotherapy is hindered by weight bias, stigma, discrimination, limited provider familiarity and bar- riers related to cost and insurance coverage, the research- ers suggested. In many cases, first-generation medications might be a preferred option because these medications and their components are often less expensive than second-gener- ation agents, the study pointed out, adding that patients might also achieve their health goals with first-generation medications and benefit from greater flexibility with dosage and administration. These medications have been found to reduce metabolic and hemodynamic abnormalities, such as hypertension, dyslipidemia, hyperglycemia and visceral adiposity, that promote atherosclerotic cardiovascular disease. In the review, the researchers also discovered that many patients required more than one medication to effectively treat obesity. As a result, many obesity medications that are either currently available or in the pipeline are combi- nations of two agents. When patients don’t achieve health goals on the highest tolerable dose of one medication, cli- nicians must be familiar with available obesity medications and know how to combine these medications safely, they advised. While the treatment strategies have been used among clinicians specializing in obesity medicine for a while, the strategies are beginning to be integrated into primary care
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