Netherlands (my home country): Ozempic is covered under the basisverzekering (mandatory basic insurance) for T2D. You pay your eigen risico (deductible, currently €385/year) and then it's fully covered.
Wegovy: available since mid-2025, NOT covered by basic insurance. Some aanvullende verzekeringen (supplementary policies) from CZ and Zilveren Kruis have started covering it with prior authorization for BMI 40+ patients.
And to reiterate: compounded semaglutide does not exist as a legal option here. The IGJ (Inspectie Gezondheidszorg en Jeugd) would shut down any pharmacy attempting it within days.
Italy: Interesting case. Ozempic is in Classe A of the AIFA formulary (fully reimbursed by SSN) for T2D. The nota AIFA 100 restricts it to patients who've failed metformin.
But here's the Italian twist: we have significant supply issues. AIFA has had Ozempic on its "carenze" (shortage) list intermittently throughout 2025-2026. When your farmacia doesn't have it, they can't just compound an alternative — you wait, or your doctor switches you to dulaglutide (Trulicity) which is more consistently available.
The Italian pharmacist underground joke: "Ozempic è come il tartufo — prezioso e introvabile." (Ozempic is like truffle — precious and impossible to find.)
Great contributions everyone. The summary for EU-based forum members:
- Compounding is not a viable option in the EU. Don't try to replicate US approaches.
- Brand-name drugs are dramatically cheaper than in the US — even without insurance, you're looking at €175-320/month vs $1,000+ in America.
- T2D coverage is universal across essentially all EU member states.
- Obesity coverage varies widely — Nordics lead, France and most of Western Europe are pending, Southern/Eastern Europe lags behind.
- If you're importing peptides from non-EU sources (US, China), be aware that customs seizure is likely and penalties can include criminal charges in some jurisdictions.
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