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UK guidance (MHRA and NICE) advises checking B12 levels in patients on metformin who develop symptoms of deficiency (anaemia, neuropathy) and considering periodic monitoring in those on long-term therapy

Yarmola EG, Klimenko ES, Fujita G, Bubb MR: Thymosin beta4: Actin regulation and more

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We do not believe a second or longer restatement process is needed for Part B rebatable drugs to account for ASP restatements in the ordinary course, because, as described previously, the reconciliation timing as set forth at 427.501(d)(1) would allow sufficient time for ASP restatement and claims run-out before the reconciliation as set forth in 427.501(d)(1) would occur

Rossi, M., Amaretti, A

TB-500 is a synthetically made iteration of thymosin beta-4, a naturally occurring peptide consisting of 43 amino acids