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As a proxy for heavy smoking (binary variable), we used diagnosis codes related to lung diseases highly associated with tobacco exposure along with diagnosis codes related to nicotine or tobacco, previous use of medications for the treatment of tobacco dependence, and initiation of drugs for obstructive airway disease after the age of 40

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Catastrophic Phase After reaching the $2,000 out-of-pocket cap in 2025, all covered Part D drugs, including metformin, are available at $0 cost-sharing for the remainder of the calendar year