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DMG levels positively correlated with methoxyestrogens and methoxyestrogen: hydroxyestrogen ratios in COC users, while S-adenosylmethionine (SAM) negatively correlated with 2-MeOE2

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(Gross spending does not account for any rebates paid by drug manufacturers to pharmacy benefit managers, which would result in lower net Medicare spending.) Gross spending on Ozempic alone increased from $2.6 billion in 2021 to $4.6 billion in 2022, pushing it to 6th place among the top-selling drugs in Medicare Part D that year, up from 10th place the year before

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