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ForumsInsurance & Access2026 payer coverage update — GLP-1 formulary changes by insurer Page 7

2026 payer coverage update — GLP-1 formulary changes by insurer

InsuranceTom Mon, Feb 26, 2024 at 4:00 PM 377 replies 33,823 viewsPage 7 of 20
mike_mealprep
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Mar 21, 2024 at 8:40 AM#31

One thing that is still open after JenPlateau’s answer:

How would you tell the difference between that and the alternative explanation?

Last edited: Mar 21, 2024 at 2:40 PM
3 1mia_MS2, LeilaHI, marcus_mpls
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hans_munich
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Munich, DE
Mar 23, 2024 at 2:55 AM#32
InsuranceTom said:
Update: approved on the third attempt after a peer-to-peer.

Careful with the causal language. Two things moving together in a period when five things changed is not a mechanism, and stating it as one makes the thread less useful to somebody reading it later.

Last edited: Mar 23, 2024 at 8:55 AM
4 2alex_tucson, kevin_tulsa, Dr.PainCLE and 1 other
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pam_columbus
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Columbus, OH
Mar 24, 2024 at 9:09 PM#33
InsuranceTom said:
Update: approved on the third attempt after a peer-to-peer.

Agreed, and one caution: a single measurement is not a measurement. Anything that moves day to day needs a trend before it means anything at all.

5 3Dr.LipidDallas, alex_tucson, kevin_tulsa and 2 others
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MounjBrad
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Mar 26, 2024 at 3:22 PM#34
InsuranceTom said:
Update: approved on the third attempt after a peer-to-peer.

Saving this. It is the first explanation that did not require me to already understand it. I will report back once I have actually tried it.

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claudia_zurich
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Mar 28, 2024 at 9:34 AM#35

Adding the clinical framing, because it changes how the question reads. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.

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