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Worse still, there are good reasons for contraindication."Activation of the RAAS also has been identified as either causing or aggravating chronic kidney disease (CKD), excessively high blood pressure, and proteinuria (excess of proteins in the blood)

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doi: 10.1093/jpids/piw010 239 VogelA

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Under the proposed three-phase framework, manufacturers of breakthrough devices accepted into the TCET pathway would enter a period of transitional coverage through a TCET national coverage determination (NCD), during which the devices manufacturer would be able to generate evidence for CMS to use to determine the breakthrough devices post-TCET final coverage status

The medications are expensive, with Saxenda costing about $500 a month