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If metformin is contraindicated (kidney impairment is a common reason), caused intolerable side effects, or failed to achieve adequate glycemic control, those outcomes all count as failure under step therapy rules and support a step therapy exception

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This approach involves the integration of services from primary care providers, endocrinologists, psychiatrists, and other healthcare professionals to ensure a cohesive treatment plan

GLP-1 drugs covered under the Bridge include tirzepatide (Zepbound, Foundayo) and semaglutide (Wegovy), prescribed specifically for weight loss

The 412 Week Timeline: Progressive Appetite Control By week 4 of semaglutide treatment, appetite suppression becomes consistent and measurable for most patients, with studies showing an average 1520% reduction in daily caloric intake during this window

Goldschmidt, T., Antel, J., Konig, F