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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

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However, annual review with your GP is advisable to: Ensure adherence to the injection schedule Monitor for any new or worsening symptoms Consider testing for other autoimmune conditions if symptoms develop (particularly thyroid function, as thyroid disease is commonly associated with pernicious anaemia) [2] Gastric cancer risk: Pernicious anaemia is associated with a slightly increased risk of gastric cancer

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