What are GLP-1 drugs
Regular follow-up with a clinician, including testing for kidney function, and discontinuation of the drug if signs of toxicity develop are advised (Curiel 2013)
However, meaningful appetite suppression, the kind that significantly reduces daily caloric intake and quiets food noise, typically develops between weeks 4 and 8 as the dose increases to 0.5 mg and reaches steady state
Key Takeaways Prescribers and pharmacies will submit prior authorization requests and claims to a CMS contractor, not Part D plans or their PBMs Detailed conditions for beneficiary eligibility specified Patients will have a copay of $50, but pharmacy reimbursement details remain to be specified Background on the BALANCE Model CMS announced the BALANCE Model in December of last year, in which CMS will negotiate directly with manufacturers on behalf of Part D plan sponsors and state Medicaid agencies for more favorable costs and terms for GLP-1 medications
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