Cost projections for oral non-peptide GLP-1 agonists — what worked for you?

DataDave said:

Denials are usually procedural rather than clinical, and the order that works reflects that.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Small molecule does not automatically mean cheap. Price is set by what the market will bear and by patent life, not by cost of goods, and I would not assume the savings reach patients.

One concrete data point for the thread. If you are going to change something, change one thing and give it long enough to express itself. Four weeks is the usual minimum for anything pharmacological on this board, and two weeks of data has told you almost nothing.

LipidDoc_ATL said:

Small molecule does not automatically mean cheap.

Adding the part of the answer the thread has not reached. The distinction that resolves most of these threads is between what is true on average and what is true for one person. Both are real; they answer different questions and get quoted as if they were the same one.

Following on from JenPlateau — and this may be the naive question:

What actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work?

Closing the loop on my own question.

Follow-up — getting the denial reason in writing was the step that mattered. It named the criterion, and the criterion was a document I already had.