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The 13 states that maintain coverage impose strict restrictions including BMI thresholds over 30, prior authorization requirements, and step therapy mandating patients first try diet, exercise, and cheaper alternatives

However, it is important to note that these benefits are only observed with a daily intake of at least 250mg of Acetyl L-Carnitine

While more studies are needed, current evidence supports their potential to reduce CV risk through multiple direct and indirect mechanisms, offering hope for improved outcomes in a population with historically elevated premature mortality