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Although the relative quiet since March might have suggested a shift in enforcement direction, the emerging pattern is that FDA conducts ongoing monitoring and then releases warning letters in coordinated batches rather than steadily over timemeaning quiet periods should not be read as reduced priority

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In January, the National Association of Medicaid Directors told the federal Centers for Medicare & Medicaid Services that state Medicaid departments had significant concerns over the fiscal impacts of the Biden proposal to require coverage of GLP-1s, and strongly recommend that CMS maintain the current state option to cover or not cover anti-obesity medications. But others say covering the drugs will yield long-term savings

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