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For Aetna commercial plans, prior authorization typically requires a letter of medical necessity from the prescribing provider documenting the patient's BMI, at least one comorbidity, participation in a structured diet and exercise program for a minimum of three months, and the clinical rationale for the requested medication

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While early and smaller trials showed promising fat-loss effects, the largest Phase IIb trial did not achieve statistical significance in humans for its primary endpoint of weight reduction, which led to the program being discontinued

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