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Successful appeals require: A Letter of Medical Necessity from the prescribing provider that specifically addresses why tirzepatide is medically necessary for this patient, why alternative treatments are inadequate, and how the patient meets the payer clinical criteria

[3] Healthcare providers may also exercise caution when prescribing these medications to individuals with kidney disease or a history of suicidal ideation or behavior

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Over a few weeks in Nov-Dec 2017 I manifested symptoms of fatigue, weakness, severe night sweats, erratic high and low blood pressure, headaches and chest pain (one time so bad I went to the ER thinking I was having a heart attack)