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Now that tirzepatide is available and the supply of oral semaglutide (Rybelsus) has been restored, I have gone back to my list of individuals who have been without their incretin-based therapy, and for many there has been a significant worsening of their HbA 1c , along with weight gain
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GLP-1 directly activates anorexigenic POMC and CART neurons and indirectly inhibits, via GABAergic transmission, orexigenic NPY and AgRP neurons [39]
The plan's Certificate of Coverage (page 47, section 8.3) lists prior authorization requirements for Wegovy but does not include step therapy as a coverage requirement
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