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The ADVANCE Collaborative Group

Preexisting conditions included (1) annual claims exceeding $500,000 in any year 20222024 and (2) blood disorders, end stage renal disease, cancer, or prior bariatric surgery during the 6month preperiod before GLP1 initiation

Such difference may arise from the subtle changes in pocket residues at 3.37b (H268 for GLP-2R, Q234 for GLP-1R and Q232 for GCGR), 3.40b (V271 for GLP-2R, V237 for GLP-1R and I235 for GCGR) and ECL2 (N334 for GLP-2R, R299 for GLP-1R and N298 for GCGR)

As a step therapy medication Contrave is a common step therapy requirement before insurance plans will approve GLP-1 medications like Wegovy or Zepbound