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This final rule with comment period will not impose a mandate that will result in the expenditure by State, local, and Tribal Governments, in the aggregate, or by the private sector, of more than $187 million in any 1 year. G

Safety Comparison# Key Differences Summary# Weight loss : Comparable (~20-21%), no head-to-head trial Mechanism : Amylin/GLP-1 (CagriSema) vs GIP/GLP-1 (tirzepatide) Molecules : Two-peptide combination vs single dual-agonist molecule Approval : Tirzepatide is FDA-approved

The peptide appears to work through multiple pathways rather than a single receptor system