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To address this gap in coverage for GLP-1s to treat obesity, CMS is launching a model called BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) under which CMS will negotiate pricing and coverage rules for GLP-1s, with the aim of expanding access to these medications and lifestyle interventions to support weight loss
They'll explain the expected timeline for seeing results at the higher dose and establish clear criteria for assessing response
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