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Scenario 1: Private Insurance with Manufacturer Program Profile: 45-year-old with employer-provided insurance (Sun Life), BMI 35, type 2 diabetes Coverage: Insurance approves after prior authorization, covers 70% after $500 deductible Calculation: Annual retail cost: $21,000 Deductible: $500 Insurance pays 70% of remaining $20,500 = $14,350 Patient owes: $6,650 Manufacturer program saves: $2,800 Final patient cost: $3,850 annually ($320/month) Verdict: Most affordable scenario