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What the PA process requires: Documentation of type 2 diabetes diagnosis (A1C ≥ 6.5% or fasting glucose ≥ 126 mg/dL) BMI documentation (most plans require BMI ≥ 27 or ≥ 30) Trial and failure of at least one other diabetes medication (usually metformin) Cardiovascular risk factors (some plans) Prescriber attestation that the medication is medically necessary Timeline: Standard PA decision: 72 hours Expedited PA (urgent): 24 hours Appeal of denial: 7 days for reconsideration, 30 days for independent review Approval rates: A 2025 analysis of Medicare Part D PA decisions found that 78% of GLP-1 PA requests were approved on first submission, 14% were approved on appeal, and 8% were ultimately denied (Johnson et al., JAMA Health Forum 2025)
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Indeed, postmenopausal women reportedly demonstrated distinctive hippocampal responses during verbal memory tasks compared with premenopausal women (247)
