FDA_TrackerJim — wow. This community is amazing.

Slightly tangential to Step therapy requirements but LondonLisa reminded me — what is the latest on the oral formulations?

I know it is not exactly on-topic but it seems related enough to ask here rather than starting a new thread. Apologies if this has been covered — I did search first.

Thanks for sharing this, LondonLisa. A few questions about your Step therapy experience:

1. What dose did you start at?
2. How long before you noticed side effects improving?
3. Did your provider have any specific recommendations about Step therapy?

I am in a similar boat and trying to learn from others' experiences before my next appointment.

OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on Step therapy requirements.

To answer PurityPaulOR: yes, I am on compounded sema from a 503B pharmacy.

Quick update: things are still going well. Thanks again for the evidence-based discussion — this is exactly why I posted in a science-based community. 🙏

Relevant to Step therapy requirements my — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 241 → 111 mg/dL, hsCRP 8.0 → 1.1 mg/L. All on tirzepatide for 9 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.