German Court Blocks Private Insurance Reimbursement for Weight‑Loss Drug Mounjaro

The Landgericht Nürnberg‑Fürth issued its final judgment on 21 May 2026, ruling that a private health insurer (PKV) is not required to reimburse the cost of the weight‑loss injection Mounjaro (tirzepatid). The court found the medication was not medically necessary for the 53‑year‑old plaintiff, who had a BMI of 34.3, type‑2 diabetes, hypertension and cardiovascular issues. He had paid more than €3,100 out of pocket and sought roughly €490 per month in compensation.

The judges emphasized that reimbursement is limited to treatments that are suitable, necessary and represent the least invasive option. They rejected the claim that the drug could serve as a primary therapy for obesity or pre‑diabetes, calling it a “lifestyle” drug. The court also noted the lack of a comprehensive therapy plan, stating that diet advice and occasional exercise were insufficient to justify coverage. The ruling sets a precedent for private insurers to deny payment for weight‑loss injections lacking clear medical necessity.