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While the agreements do not address prices charged to employer health plan sponsors and covered plan members, as drug manufacturers have begun making GLP-1 medications available well below list price through their own direct-to-consumer programs, the major PBMs say they have generally been able to negotiate discounts and rebates for group health plans that effectively bring net costs for these drugs close to DTC costs

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Furthermore, pond cultivation of Spirulina remains at great risk for contamination by diverse microzooplanktons that can affect yield and cause losses (Yuan et al

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