Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the talking.
What I am trying to establish is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
Taking the question as asked, rather than the general version of it. SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1. Different trials, different populations, so the comparison is indicative rather than decisive — but SURPASS-2 was a genuine head-to-head and it pointed the same way.
MikeFit_NJ said:SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1.
Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.
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Browse GL BiochemTomFromTexas said:Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…
True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of people never reach the dose the headline number came from.
Correct me if the detail matters more than I have assumed.
From the other side of the consultation, briefly.
My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.