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The regulations at 42 CFR 412.85(c) also specify that the adjustment factor will reflect the average cost for cases to be assigned to MS-DRG 018 that involve expanded access use of immunotherapy or are part of an applicable clinical trial to the average cost for cases to be assigned to MS-DRG 018 that do not involve expanded access use of immunotherapy and are not part of a clinical trial (85 FR 58844)

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In clinical practice, individualized drug regimens need to be developed based on patient-specific conditions, and therapeutic drug monitoring and individualized genetic testing are effective tools to increase the efficacy and decrease the adverse effects of metformin for PCOS therapy