These may still apply to legacy contracts, but for Medicare Advantage plan year 2025 onward, V28 applies
As prescribing patterns continue to evolve, staying informed will help healthcare providers navigate these complexities with confidence
Systemic effects that have been reported in trials, or that are mechanistically expected from elevated GH and IGF-1, include: Water retention and mild edema , particularly in the hands, ankles, and face Tingling, numbness, or 'pins and needles' (paresthesia) , sometimes linked to fluid pressure on nerves Headache and facial flushing , often shortly after administration Joint aches or stiffness (arthralgia) Transient changes in blood glucose due to GH's counter-regulatory effect on insulin Fatigue, dizziness, or a feeling of light-headedness in some individuals It is important to be candid about the limits of this evidence
Dosing regimens have ranged from 350 g per week (in vegetarians) to 2000 g per day in a study including patients with pernicious anaemia, with the most common daily dose being 1000 g per day
