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Since GLP-1 is an incretin hormone playing an anti-diabetic role, GLP-1 increase after bariatric surgery has also been regarded as a central event in RYGB-induced remission of T2DM (Rhee et al., 2012)

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The FTC and members of Congress on both sides of the aisle have raised concerns that this level of market concentration and vertical integration enables PBMs to steer consumers to their preferred pharmacies, mark up the cost of drugs dispensed at their affiliated pharmacies, reimburse PBM-affiliated pharmacies at a higher rate than unaffiliated pharmacies for certain drugs, and apply pressure over certain contractual terms, all of which may disadvantage unaffiliated and independent pharmacies, contributing to pharmacy closures

This separation protects both clarity and compliance