For beneficiaries to be eligible under the BALANCE Model, providers must attest that they meet certain clinical criteria, including qualifying for a GLP-1 for a currently covered use (such as type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea) or for use to treat obesity based on similar clinical criteria as applied in the Medicare GLP-1 Bridge (Figure 3)
Clinical trials for tirzepatide found that roughly 5% of participants experienced noticeable hair shedding, compared to less than 1% on placebo
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Protocol 3: long-term maintenance (for persistent mild symptoms) Goal: Comfortable long-term adherence with minimal GI disruption
Universal insurance plan coverage Its not good enough that Medicare and Medicaid cant (in the case of Medicare) or wont (many state Medicaid programs) cover GLP-1s for weight loss
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