I am an obesity medicine specialist and I oppose several of the proposed changes.
For a patient with class I obesity, and CAD or DM II, they should be eligible for saxenda and wegovy. These are two major comorbidities that are significantly improved by GLP-1 RA and weight loss.
Should NOT have to have tried another drug within 6 months. If they didn't tolerate a drug in the past, I would not re-prescribe as that could cause patient harm. The requirement should be that they have tried another drug for weight loss in the past OR other drugs are not indicated due to their medical comorbidities.
Requiring assessment by RD is unnecessary step that will disproportionately effect more remote patient populations as these areas are unlikely to have access to an RD.
Change "member not currently on other GLP1- RA" to "Patient will not be on two GLP-1 RAs at the same time" We often have to switch between GLP-1 RA s for various reasons, which requires both to be active at the same time.