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The typical denied patient: Female, age 38 to 52 BMI 32 to 41 Prediabetes (A1C 5.9% to 6.3%) or newly diagnosed type 2 diabetes (A1C 6.5% to 7.2%) Medicaid coverage through a state that requires A1C above 7.5% for GLP-1 approval Tried metformin for 60 to 90 days with partial response (A1C dropped from 7.0% to 6.7%, not enough to meet state threshold) Provider submitted PA, denied for "A1C not above threshold" The denial is technically correct under the state's criteria, but clinically frustrating
Although compounded semaglutide may be similar to Wegovy, these products have not been tested for safety and effectiveness in clinical trials, and are not exactly the same
A number of studies support the use of GLP-1 for weight loss
However, without controlled studies it remains unclear whether the degree of weight loss, the consistency of results, or the side effect profile matches what has been observed in clinical trials of FDA approved products
