CMS Semaglutide Coverage Expansion Could Save Millions of Lives, Advocates Say

CMS Semaglutide Coverage Expansion Could Save Millions of Lives, Advocates Say

A group of health care and advocacy organizations is urging the Centers for Medicare & Medicaid Services (CMS) to expand coverage and access to semaglutide for the treatment of obesity. Doing so, the group says, could mitigate the detrimental outcomes and comorbidities that often develop as a result of obesity, a disease that places significant burdens on individuals and the health care system.

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PCSK9 Rejections: It's Not Just You

Just how hard is it to get insurance to cover PCSK9 inhibitor prescriptions? Two large claims databases showed about 80% of scripts were rejected on the first attempt.

In one analysis involving 44,234 new prescriptions for PCSK9 inhibitors in the QuintilesIMS databases from July 29, 2015, through July 15, 2016, just 17% of of the scripts were approved on the first attempt. With further paperwork, another 26% got approved, for an ultimate approval rate of 43%.

Read more at MedPage Today.