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The rebate system creates a perverse incentive for high list prices: manufacturers must price high to generate rebates large enough to secure favorable formulary placement, and PBMs benefit from larger rebates by keeping a portion, not from lower drug costs

Medicines with a narrow therapeutic index may require additional monitoring, and warfarin may require more frequent INR monitoring when initiating GLP-1 therapy

Gastrointestinal side effects generally subside, though occasional nausea or constipation may persist

For Barkley, the result has been one of the most visible health transformations in sports media