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If you have NASH without diabetes or obesity, approval requires submitting a prior authorization with: Biopsy or imaging confirmation of NASH with fibrosis stage F2 or higher Documentation of failed standard treatments (vitamin E, pioglitazone, lifestyle modification for at least 6 months) Peer-reviewed evidence supporting GLP-1 use in NASH A letter of medical necessity from a hepatologist or gastroenterologist Approval rate: 15-25% on first submission, 30-40% after appeal with additional specialist documentation
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