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The typical denied patient: Female, age 38 to 52 BMI 32 to 41 Prediabetes (A1C 5.9% to 6.3%) or newly diagnosed type 2 diabetes (A1C 6.5% to 7.2%) Medicaid coverage through a state that requires A1C above 7.5% for GLP-1 approval Tried metformin for 60 to 90 days with partial response (A1C dropped from 7.0% to 6.7%, not enough to meet state threshold) Provider submitted PA, denied for "A1C not above threshold" The denial is technically correct under the state's criteria, but clinically frustrating

Data also show that more than 400,000 items of tirzepatide and semaglutide were dispensed on the NHS in October 2025

Biol Pharm Bull 30 , 20582062 (2007)

Anti-Doping Agency (USADA) [Internet]