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As estrogen declines, the hypothalamus, which controls body temperature, becomes hypersensitive to small fluctuations in heat
The outcomes: Approved on first submission: 34% (286 requests) Denied, then approved on appeal with additional documentation: 29% (244 requests) Denied, appeal denied, patient switched to compounded semaglutide: 31% (260 requests) Denied, patient abandoned treatment: 6% (50 requests) The pattern that emerges: patients who succeed in getting Wegovy covered through Express Scripts are patients whose providers submitted complete documentation on the first attempt