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Toft-Nielsen, M., Madsbad, S

Metformin remains widely used due to its affordability and long safety record

But it was not significant for insulin levels

Typical criteria: BMI 30 (or 27 with hypertension, type 2 diabetes, sleep apnea, etc.) 3-6 months documented lifestyle efforts (diet and exercise in your medical record) No concurrent GLP-1 use (can't take Ozempic, Wegovy at same time) Step therapy: Some plans require trying other meds first Renewal: Must show 5% weight loss to continue coverage For complete documentation checklists and PA preparation: Zepbound Prior Authorization Guide denied approved Honest Care helps patients fight back: Evidence-backed appeal letters plus personalized guidance to appeal with confidence