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At therapeutic doses it is safe for most people, but acetaminophen metabolism uses glutathione directly, and chronic high dose use is the leading cause of acute liver failure in the United States precisely because it exhausts hepatic glutathione (PubMed PMID: 26041729)

This spike is driven by high utilization and complex PBM models, where opaque pricing and rebate structures can limit employers' ability to capture the lowest net drug prices

These complications often lead to repeated doctor visits and, in some cases, hospital stays

Insurers may also calculate that the long-term health care cost savings due to a decline in obesity and related health issues is an attractive reason to pay for the treatments