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Initial research has found that these medications may improve outcomes in people with conditions ranging from sleep apnea and fatty liver disease to heart and kidney disease
Combining semaglutide with other glucoselowering drugs can also increase the risk of hypoglycemia
It is also worth consider the alternatives of vitamin B12 capsules or sprays, which tend to be the purest forms
Small-molecule drugs such as orforglipron offer better oral bioavailability, but their receptor interaction profile may differ subtly from that of peptide GLP-1 agonists, which could account for some of the efficacy differential
For state PBM laws, ERISA preemption creates a structural limitation: a state can regulate PBM practices for state-regulated insurance plans (Medicaid managed care, fully-insured commercial plans), but cannot directly regulate the pharmacy benefit for self-insured ERISA plans, which cover approximately 60% of the commercially insured population
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