Weight-loss injection

What is the weight-loss injection?

“Weight-loss injection” is the common name for medicines from the group of GLP-1 receptor agonists that are authorised for weight management. The best known are Wegovy, with the active substance semaglutide, and Mounjaro, with the active substance tirzepatide. You inject them yourself under the skin once a week using a prefilled pen. According to the FOPH, tirzepatide, for example, regulates appetite, reduces food intake and slows down gastric emptying.

The medicines are authorised by Swissmedic: Wegovy for weight management since 15.02.2022, Mounjaro since 09.07.2024. Authorisation, however, only means that the medicine may be sold. Whether your health insurer pays for it is decided separately by the FOPH: basic health insurance only routinely pays for medicines on the List of Pharmaceutical Specialties (SL), and often only under conditions known as the limitation.

For weight-loss injections the limitation is particularly strict. In this way, the FOPH wants to ensure that these expensive medicines are only used for people with a high medical need, where a large benefit can be expected. If you want to lose weight without meeting these requirements, you pay for the injection yourself.

Weight-loss injections should not be confused with Ozempic. Ozempic also contains semaglutide but is authorised for the treatment of type 2 diabetes. The FOPH considers reimbursing Ozempic for weight management to be unlawful.

How it works

For basic health insurance to pay for a weight-loss injection, all conditions of the limitation must be met. They are largely the same for Wegovy and Mounjaro:

• Weight: You are an adult and have a BMI of at least 35, or a BMI of at least 28 with a weight-related condition: prediabetes or type 2 diabetes, high blood pressure or a lipid metabolism disorder.
• Accompanying measures: The injection supplements a diet with a deficit of 500 kcal a day, accompanying nutritional advice and more physical activity that is documented, for example with a step counter. Compliance with the diet must be confirmed to the insurer.
• Prescription: Only specialists in endocrinology/diabetology or obesity centres that meet the criteria of the limitation may prescribe it: at least 100 people with obesity treated per 12 months for a specialist, at least 300 for a centre. For both Wegovy and Mounjaro, the prescription and progress checks must take place in person, not via telemedicine.
• Cost approval: The insurer must agree in advance, after consulting its medical adviser.
• Progress check: After 16 weeks you must have lost at least 5% of your starting weight (BMI 28 to under 35) or 7% (BMI 35 or more). After a further six months, the total must be 10% or 12%. Continuing requires new cost approval, followed by checks every six months.
• Duration: Basic health insurance pays for three years at most in total, even if you switch between products. If your BMI falls below 25, the therapy is ended.

The injection may not be combined with other GLP-1 medicines or other weight-loss medicines. If your insurer covers the costs, you pay the deductible and retention fee as with any medicine.

Legal basis

Under Art. 52 para. 1 let. b of the Health Insurance Act (KVG), the FOPH draws up the List of Pharmaceutical Specialties with the medicines and prices that basic health insurance covers. A medicine must be effective, appropriate and cost-effective (Art. 32 KVG). The FOPH can attach a limitation to the listing and make it time-limited. Wegovy was listed as of 01.03.2024, limited until 28.02.2027; at the time of listing the public price was CHF 188.15 per prefilled pen, and it is now CHF 176.95, the same for all doses (as of 25.09.2026). Saxenda (liraglutide) is no longer on the List of Pharmaceutical Specialties. The limitation for Mounjaro for weight management has applied since 01.01.2026 and is limited until 31.12.2027. The current prices and limitations are published on spezialitaetenliste.ch.

Outside the limitation, basic health insurance can only pay for a medicine in individual cases (Art. 71a–71b KVV). This requires that a large therapeutic benefit against a serious illness can be expected and that no other effective treatment is available. In its letter to insurers of 15.05.2025, the FOPH states that these requirements are not met for weight management outside the limitation, and that coordination via online services or online practices is ruled out.

Example: who is eligible?

Daniel is 45, 1.75 m tall and weighs 110 kg. His BMI is 110 ÷ (1.75 × 1.75) = 35.9. He is therefore above the threshold of 35 and would be eligible for reimbursement without a related condition, provided all other conditions are met.

What this means for you

1. Clarify the requirements with a specialist. Your GP can refer you to a specialist in endocrinology/diabetology or to an obesity centre. Only there can it be prescribed at the expense of basic health insurance.
2. Wait for cost approval. Only start the therapy once your insurer has agreed in writing. Otherwise you risk bearing the costs yourself.
3. Plan for the co-payment. With a therapy lasting several months you will probably reach your deductible. Whether a lower deductible is therefore worthwhile, you can work out in the premium calculator. The deadline for a lower deductible is 30 November, see deadlines.
4. Ask your supplementary insurer. Whether it covers anything outside the limitation is set out only in your contract. You can find the insurers’ offers under health insurers.

You can read more about prices and co-payments for medicines under medicines.

Common mistakes

• Ordering the injection online and submitting the bill. According to the FOPH, online medical practices do not meet the requirements for prescription. The insurer must reject such prescriptions.
• Expecting Ozempic for weight loss. Ozempic is authorised for diabetes. Basic health insurance does not reimburse it for weight management.
• Starting without cost approval. Without the insurer’s prior agreement there is no reimbursement.
• Not documenting the diet. Compliance with the diet is a requirement and must be confirmed to the insurer.
• Expecting unlimited therapy. Reimbursement by basic health insurance ends after three years in total.

We explain how we build our examples under How we calculate.