Revisiting: German, French and Dutch differences, compared

Posting this under the heading it deserves: Revisiting: German, French and Dutch differences, compared Everything below is what sits behind that.

I have spent a fortnight trying to pin German down and I want to set out where I have got to, because I suspect the honest answer is duller than the thread this will produce.

What I have: a consistent observation across a small number of cases, collected the same way each time. What I do not have: any controlled comparison, or any reason to think my cases are representative.

The specific question is whether the pattern survives once the obvious confounder is removed. I cannot remove it with what I have.

Counterpoint on German, offered without confidence: the same observation is consistent with a much duller explanation, and nobody has ruled the dull one out.

What I can speak to on German is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know.

Everything in post #2 holds. The case it does not cover is the one I have.

Netherlands: CBG-MEB implements framework. GPs are first point of contact. Insurance coverage for weight management is conditional on structured lifestyle programme participation.

A single observation, in a thread that deserves better than single observations.

One more thing on German that took me far too long to see: the two figures people quote are not measuring the same quantity. Once you notice that, the apparent contradiction disappears.

Summarising the German thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length.

Post #4 answers the question as asked. The question underneath it is different.

Members outside the union should note that essentially none of this transfers, including the parts phrased generally.

That is what the documentation says. What happens in practice is usually close.

I read post #6 twice before replying, because I had assumed the opposite.

Correcting a stale claim here is more valuable than adding a new one, because the stale claims are what people find first.

The reasoning is more useful than the number, which is why I have shown it.

Adding a reference point for German. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.

Understood. Thank you for being specific about the limits of it.

Post #9 put the caveat in the right place and I want to underline it.

The public assessment report published at authorisation is one of the best free technical documents available on any of these compounds and it is rarely cited here.

Caveat: everything above assumes the paperwork is what it says it is.

Building on post #9 rather than restating it.

What I would check first on German is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

The number people quote for German is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

Germany: BfArM implements EU framework. Statutory insurance (the majority) excludes "lifestyle medicines" including weight management. Private prescription is common. Private insurance sometimes covers it.