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Insurance companies, including Medicare, follow a principle of step therapy. This means they want to see that less invasive and more conservative treatments have been tried before they will approve a more advanced or surgical procedure

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The next question involves regulatory redundancy

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Nonetheless, for GLP-1 and other specialty meds, the push toward ePA has accelerated because every 30% reduction in approval time translates into concrete gains in patient outcomes (timely titration) and provider efficiency ( [45] ) ( [46] )