Yeah

... every other chronic disease, right? And so when Part D was passed, Part D being the, the pharmacy benefit that sets formularies for Medicare beneficiaries, it, in, in written into the law, uh, excluded medicines for weight management, which they really framed as cosmetic for weight loss at the time, and that had to do with a lot of the legacy bias around diet pills and, and diet eras and, and the like.

And it wasn't till later that, you know, CMS, the American Medical Association formally came out and made statements and resolutions to the effect that obesity is a biological chronic health issue, chronic disease, it needs to be afforded the treatment that all other chronic diseases, uh, are afforded.

And, and so the issue we ran into is we're dealing with legacy statutes within the, the sort of description of benefits for, um, you know, our seniors, and, uh, and that has to be redone, updated, changed for it to meaningfully sort of percolate, you know, in the market.

And, and, and the relevance in all of this is that this is the first time since Part D was passed in 2003 that the government has committed to covering obesity medications for the specific intent of helping people manage their weight long term.

Mm-hmm

... picking up the rest.

Um, and I, I, I think just, you know, with everything, just making sure that the pharmacies process this correctly.

Yeah

... for every other chronic disease, right? And so when Part D was passed, Part D being the, the pharmacy benefit that sets formularies for Medicare beneficiaries, it- In, in-- written into the law, uh, excluded medicines for weight management, which they really framed as cosmetic for weight loss at the time.

And that had to do with a lot of the legacy bias around diet pills and, and diet eras and, uh, and the like.

And it wasn't until later that, you know, CMS, the American Medical Association formally came out and made statements and resolutions to the effect that obesity is a biological chronic health issue, chronic disease, it needs to be afforded the treatment that all other chronic diseases, uh, are afforded.

And, and so the issue we ran into is we're dealing with legacy statutes within the, the sort of description of benefits for, um, you know, our seniors.

And, uh, and that has to be redone, updated, changed for it to meaningfully sort of percolate, you know, in the market.

And, and, and the relevance in all of this is that this is the first time since Part D was passed in two thousand and three that the government has committed to covering obesity medications for the specific intent of helping people manage their weight long term.

So who will qualify for GLP-1s in the Medi- Medicare Bridge Program?

So why might some of these things have unintended consequences that maybe people aren't aware of?

Yeah, I think melanotan II is a really great example of that.

So it's a non-selective, uh, melanocortin receptor agonist.

It activates multiple different receptor types, which downstream of those receptors has a whole host of different effects, be it sexual, be it increased melanin production, be it, uh, different vascular properties and cardiac physiologic effects.

And it turns out this compound was designed to help stimulate melanin production as, and increase, you know, uh, the, the sort of melanin and pigment of, of one's skin, and there are already case reports that it is causing an increase in incidence in melanoma and cardiovascular events.

And so there's a real active safety signal due to the nonspecific, non-selective nature of the way the peptide engages these various receptor types.

So one of the concerns we have about not having enough data, we at least have some data for melanotan, which is why it's getting this adverse event warning, but not having enough is this non-selective nature of peptides, right? It's, it might be-- a peptide might be a key that unlocks many doors, and some of those doors may be totally legit and may be great and trigger the type of physiologic effect you want, like cellular healing, right? Or weight loss.

As we wrap up here, is there any key points that you think we missed or that we should be adding on to this discussion?