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c/insurancefights·submitted 1 year ago by u/rekha_vestergaard

[Question] how do you actually verify external review

Questionbranch of 6 comments

Been lurking in c/glp1eu for about 14 months and finally have something worth posting. Short version: week 7, 15mg, and denial is the bit I still cannot get a straight answer on. I have read the wiki, I have read the last 3 threads, and the answers split roughly down the middle. What I actually want to know is…

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6 comments, started 1 year ago
u/peak_area_peteanalytical3 points·1 year ago

Titration speed is a side-effect dial far more than an efficacy dial.

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u/camila_vasquez1 point·1 year ago

Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.

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u/hplc_hobbyistruns their own column1 point·1 year ago

Small correction: the trial was 10 weeks, not 4. Does not change your point but people will quote it.

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u/hugo_pires1 point·1 year ago

Slight fix: the number was 97.4, not 97.2. Decimal point, but a fairly consequential one.

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u/rekha_vestergaardOP1 point·1 year ago

Slight fix: the number was 97.4, not 97.2.

Adding to this: formulary is doing more work than the comment implies.

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u/rekha_vestergaardOP1 point·1 year ago

formulary exclusions are negotiable sometimes

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The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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