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This is not surprising, considering that tirzepatide and semaglutide evoked more pronounced TBWL and also have glucose-lowering effects by slowing gastric emptying, stimulating insulin secretion and inhibiting glucagon secretion in a glucose-dependent manner, independent of their effects on body weight 50,51

GLP-1 receptor agonists also slow gastric emptying, reduce appetite through central nervous system pathways, and promote satiety, leading to reduced caloric intake and weight loss

and cardiovascular death HR 0.93

Overall, across PBMs the consensus access policy is very tight : PBMs uniformly require prior authorization for GLP-1s used for obesity, almost always mandate step therapy, and site-of-care is typically limited (e.g