According to Bloomberg, a spokesperson from the Michigan insurer cited consideration of the drugs effectiveness, safety and cost in reaching this decision, but did not respond to a question about what the safety concerns were. 2 According to the BCBS Michigan provider alert itself, the decision was based on a number of factors, including research indicating weight loss success is significantly higher when medication is used in combination with lifestyle changes such as diet and exercise rather than on its own
Users Prioritizing Long-Term Affordability: Individuals evaluating total cost of ownership across six-month, twelve-month, or multi-year treatment timelines rather than focusing solely on initial monthly rates benefit from the zero price increase guarantee protecting against competitor practices where initially attractive pricing transforms into premium-tier costs after several months
The drug manufacturers, Novo Nordisk and Eli Lilly, have agreed to a net price of $245 per monthly supply, and they owe CMS the difference between the WAC and that $245 figure
doi: 10.1016/j.theriogenology.2011.11.006 83 PartykaA.NiaskiW
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