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State participation in the Medicaid Drug Rebate Program requires coverage of nearly all FDA-approved drugs for medically accepted indications, but weight-loss drugs are included in a small group of drugs that can be excluded from coverage
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Tirzepatide produces slightly greater average weight loss in head-to-head trials, but the difference is 3-5 percentage points of body weight, not a categorical improvement (Jastreboff et al., NEJM 2022)
