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In DPPOS year 9, vitamin B 12 deficiency rates were 4.4%, 5.9%, and 4.9% for GG, AG and AA genotype groups in the placebo arm, vs 5.7%, 6.6%, and 18.7% in those respective genotype groups in the metformin arm (ESM Table 9)

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These include the elderly, vegetarians and vegans, individuals with malabsorptive disorders (such as Crohn's disease, coeliac disease and post-bariatric surgery patients), those with pernicious anaemia, and individuals taking certain medications like metformin and proton pump inhibitors

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[605] Billing activity in the Medicare FFS program at a scale warranting a special assumption for calculating the USPCC or Federal budget forecasts has per se national or regional significance, and thus would likely rise to the high bar of warranting adjustment to Shared Savings Program expenditure and revenue calculations