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The FDA-approved drug Ozempic is primarily used for glycaemic control in type 2 DM patients but is also being used off-label for its weight loss properties
The notice primarily affects 503B outsourcing facilities, which most consumer-facing telehealth platforms have already transitioned away from in favor of 503A pharmacy networks
Participating plans including UnitedHealthcare, Humana, Cigna, CVS Health Aetna, and over 30 Blue Cross Blue Shield entities have committed to: curtailing the number of claims requiring PA, honoring existing PAs for 90 days when patients switch plans, and providing clear explanations for PA determinations including appeals guidance ( [72] )
Retatrutide is a separate investigational molecule
