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10: 189224 Sonobe M, Yasuda H, Hisanaga T, et al
Cloake et al., 2018
The outcomes: Approved on first submission: 34% (286 requests) Denied, then approved on appeal with additional documentation: 29% (244 requests) Denied, appeal denied, patient switched to compounded semaglutide: 31% (260 requests) Denied, patient abandoned treatment: 6% (50 requests) The pattern that emerges: patients who succeed in getting Wegovy covered through Express Scripts are patients whose providers submitted complete documentation on the first attempt
Even small changes in medication absorption can make a difference, she adds
This includes any possible side effects not listed in this leaflet
No lengthy explanations are required
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