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ICER also noted that an oral version of semaglutide, now under regulatory review, appears cost-effective compared with lifestyle changes, but its value compared with injections remains uncertain

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The lawsuit, filed Wednesday in the Southern District of New York, alleges that the change from CVS Caremark and subsequent denials of patient and doctor appeals violates standards for evaluating the medical necessity of treatment options under the Employee Retirement Income Security Act, which is applicable to employer-sponsored health plans