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For the OSA indication, separate criteria apply: Polysomnography documenting moderate-to-severe OSA (typically AHI 15+) BMI 30 or higher CPAP intolerance, insufficiency, or contraindication documentation Sleep medicine physician co-signature in some plans The December 2024 OSA pathway The FDA's December 2024 approval of tirzepatide (Zepbound) for moderate-to-severe obstructive sleep apnea in adults with obesity, based on the SURMOUNT-OSA trials (Malhotra et al., New England Journal of Medicine 2024), created a new coverage pathway

Gruber CW, Cemazar M, Heras B, Martin JL, Craik DJ

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Svoboda M, Tastenoy M, Vertongen P, Robberecht P