The altered pharmacokinetics in advanced liver disease and the potential for medication-related complications require careful consideration of risks and benefits
Through the October 2025 OPPS quarterly update CR (Transmittal 13425, Change Request 14223, dated September 22, 2025), we recognized several new codes for separate payment and assigned them to appropriate interim OPPS status indicators and APCs
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Here we compare the published data from the STEP-1, SURMOUNT-1, and TRIUMPH-4 trials without marketing spin: -14,9% for semaglutide, -20,9% for the tirzepatide-28,7% for the retatrutideThe retatrutide vs tirzepatide vs semaglutide comparison also incorporates tolerance (dysesthesia 20,9% at the 12 mg dose level of retatrutide), pleiotropic effects 2024-2025 (apnea, heart failure, MASLD), and the updated regulatory status in France 2026
Those who struggle with these symptoms may need injections to meet their nutritional needs
