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In non-diabetic individuals, glucagon is only released from the pancreas when blood sugar levels are low, and glucagon secretion is shut off after meals by insulin and by GLP-1

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Standard PA criteria across payers typically include: Confirmed diagnosis of primary hyperlipidemia or HeFH or HoFH with supporting ICD-10 code Documented LDL-C level above payer-specified threshold (commonly 70 mg/dL or 100 mg/dL depending on cardiovascular risk category) Evidence of maximally tolerated statin therapy or documented statin intolerance Prescribing clinician is a cardiologist, lipidologist, or relevant specialist (some plans require specialist involvement) Previous trial of other LDL-lowering therapies (PCSK9 inhibitors or ezetimibe, plan-specific) Maintaining thorough PA documentation in secure patient records is essential for both initial approvals and denial appeals