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Comment: Commenters requested that CMS eliminate or waive the productivity adjustment for CY 2026 and going forward using CMS' special exceptions and adjustments authority under section 1886(b)(3)(B)(xi) of the Act, which would justify special circumstances

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Analytical verification methods are applied to confirm peptide identity, chemical purity, and batch consistency across production lots

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People with the following should discuss risks carefully with a medical professional: Liver disease Kidney disease Pernicious anemia Known allergies to any ingredient in the formulation Pregnancy or breastfeeding (safety not well-studied avoid unless prescribed) Because ingredients differ between providers, always verify the formulation and follow prescribed dosing to minimize risk

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