1. Insurance prior authorization + appeal
Who qualifies
Patients with commercial insurance, Medicaid, or Medicare Part D (T2D indication).
How to access
Ask your prescriber to submit a prior-auth request with FDA-approved indication, diagnosis codes, and clinical justification. If denied, file a formal appeal — appeals are granted ~40–60% of the time per Kaiser Family Foundation data.
Average savings
Up to 95% of list price when approved (typical $25–$100/mo copay vs $1,000+ cash). Source: KFF.
Source: https://www.kff.org/health-costs/issue-brief/prior-authorization-in-medicare-advantage/
Letter of Medical Necessity template