diff --git a/domains/health/glp1-access-inverted-by-cardiovascular-risk-creating-efficacy-translation-barrier.md b/domains/health/glp1-access-inverted-by-cardiovascular-risk-creating-efficacy-translation-barrier.md
index ad9c946ae..da404673a 100644
--- a/domains/health/glp1-access-inverted-by-cardiovascular-risk-creating-efficacy-translation-barrier.md
+++ b/domains/health/glp1-access-inverted-by-cardiovascular-risk-creating-efficacy-translation-barrier.md
@@ -15,3 +15,9 @@ related_claims: ["[[GLP-1 receptor agonists are the largest therapeutic category
 # GLP-1 anti-obesity drug access is structurally inverted: populations with greatest cardiovascular mortality risk face the highest costs and lowest coverage rates, preventing clinical efficacy from reaching population-level impact
 
 ICER's 2025 access analysis reveals a structural inversion: the populations with greatest cardiovascular mortality risk (lower SES, Black Americans, Southern rural residents) face the highest out-of-pocket costs and lowest insurance coverage rates for GLP-1 anti-obesity medications. In Mississippi, continuous GLP-1 treatment costs approximately 12.5% of annual income for the typical individual. Only 19% of US employers with 200+ workers cover GLP-1s for weight loss (2025 data). Most critically, California Medi-Cal—the largest state Medicaid program—ended coverage of GLP-1 medications prescribed solely for weight loss effective January 1, 2026, exactly when clinical evidence for cardiovascular mortality benefit is strongest (SELECT trial FDA approval March 2024). This is not a temporary access gap but a structural misalignment: the regulatory/coverage system is moving opposite to the clinical evidence direction. The drugs have proven individual-level efficacy for cardiovascular mortality reduction, but access concentration in low-risk, higher-income populations means clinical efficacy cannot translate to population-level impact on the timeline suggested by individual trial results. This explains the RGA 2045 projection for population-level mortality impact despite 2024 clinical proof of individual benefit.
+
+### Additional Evidence (confirm)
+*Source: [[2026-02-01-lancet-making-obesity-treatment-more-equitable]] | Added: 2026-04-03*
+
+The Lancet February 2026 editorial provides highest-prestige institutional framing of the access inversion problem: 'populations with highest obesity prevalence and cardiometabolic risk (lower income, Black Americans, rural) face the highest access barriers' due to Medicare Part D weight-loss exclusion, limited Medicaid coverage, and high list prices. Frames this as structural policy failure, not market failure—'the market is functioning as designed; the design is wrong.'
+
diff --git a/domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md b/domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md
index 8b0c48770..6907cd73c 100644
--- a/domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md
+++ b/domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md
@@ -70,6 +70,12 @@ OBBBA work requirements threaten to remove ~10M from Medicaid coverage precisely
 
 PCSK9 inhibitors show sociodemographic disparities in utilization independent of clinical indication. JAHA 2021 adoption study found Black and Hispanic ASCVD patients had lower PCSK9 utilization than white patients at all income levels. This pattern parallels GLP-1 discontinuation disparities, suggesting affordability/access barriers create systematic underutilization in lower-income and minority populations across multiple high-cost cardiovascular/metabolic drug classes.
 
+### Additional Evidence (extend)
+*Source: [[2026-02-01-lancet-making-obesity-treatment-more-equitable]] | Added: 2026-04-03*
+
+The Lancet connects discontinuation patterns to structural access barriers: Medicare Part D exclusion and Medicaid coverage gaps create affordability constraints that drive persistence differences. The equity-efficacy paradox means cardiovascular mortality benefits will 'disproportionately accrue to already-advantaged populations' because access structure is inverted relative to need.
+
+
 
 Relevant Notes:
 - [[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]
diff --git a/domains/health/medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md b/domains/health/medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md
index c283e0d6a..b04fdabad 100644
--- a/domains/health/medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md	
+++ b/domains/health/medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md	
@@ -81,6 +81,12 @@ PNAS 2026 attributes US life expectancy stagnation to 'a complex convergence of
 
 Hypertension-related CVD mortality doubled 2000-2023 (23→43 per 100,000) despite widespread availability of effective, cheap generic antihypertensives. This is the strongest single empirical case for the 80-90% non-clinical determinants thesis because the failure occurs despite pharmacological solutions being universally accessible, proving the constraint is behavioral/SDOH not medical.
 
+### Additional Evidence (extend)
+*Source: [[2026-02-01-lancet-making-obesity-treatment-more-equitable]] | Added: 2026-04-03*
+
+The Lancet frames GLP-1 access gap as exemplifying Belief 2 (health outcomes determined by social/economic factors): the most effective cardiovascular intervention of the decade has an access structure that will perpetuate rather than reduce health disparities. Structural policy changes required include insurance mandates, generic competition, global procurement frameworks—none imminent in US context.
+
+
 
 
 Relevant Notes:
diff --git a/inbox/queue/.prior-art/2026-02-01-lancet-making-obesity-treatment-more-equitable.txt b/inbox/queue/.prior-art/2026-02-01-lancet-making-obesity-treatment-more-equitable.txt
new file mode 100644
index 000000000..ae868601b
--- /dev/null
+++ b/inbox/queue/.prior-art/2026-02-01-lancet-making-obesity-treatment-more-equitable.txt
@@ -0,0 +1,12 @@
+## Prior Art (automated pre-screening)
+
+- [lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence](domains/health/lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md) — similarity: 0.61 — matched query: "GLP-1 access equity"
+- [glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints](domains/health/glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints.md) — similarity: 0.57 — matched query: "GLP-1 access equity"
+- [GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035](domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md) — similarity: 0.56 — matched query: "GLP-1 access equity"
+- [semaglutide-reduces-kidney-disease-progression-24-percent-and-delays-dialysis-creating-largest-per-patient-cost-savings](domains/health/semaglutide-reduces-kidney-disease-progression-24-percent-and-delays-dialysis-creating-largest-per-patient-cost-savings.md) — similarity: 0.55 — matched query: "semaglutide affordability policy"
+- [glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics](domains/health/glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics.md) — similarity: 0.54 — matched query: "GLP-1 access equity"
+- [medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm](domains/health/medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md) — similarity: 0.52 — matched query: "Making Treatment for Obesity More Equitable"
+- [generic-digital-health-deployment-reproduces-existing-disparities-by-disproportionately-benefiting-higher-income-users-despite-nominal-technology-access-equity](domains/health/generic-digital-health-deployment-reproduces-existing-disparities-by-disproportionately-benefiting-higher-income-users-despite-nominal-technology-access-equity.md) — similarity: 0.52 — matched query: "obesity treatment disparities"
+- [semaglutide-achieves-47-percent-one-year-persistence-versus-19-percent-for-liraglutide-showing-drug-specific-adherence-variation-of-2-5x](domains/health/semaglutide-achieves-47-percent-one-year-persistence-versus-19-percent-for-liraglutide-showing-drug-specific-adherence-variation-of-2-5x.md) — similarity: 0.51 — matched query: "GLP-1 access equity"
+- [SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action](domains/health/SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent and no operational infrastructure connects screening to action.md) — similarity: 0.51 — matched query: "Making Treatment for Obesity More Equitable"
+- [only-23-percent-of-treated-us-hypertensives-achieve-blood-pressure-control-demonstrating-pharmacological-availability-is-not-the-binding-constraint](domains/health/only-23-percent-of-treated-us-hypertensives-achieve-blood-pressure-control-demonstrating-pharmacological-availability-is-not-the-binding-constraint.md) — similarity: 0.50 — matched query: "obesity treatment disparities"
diff --git a/inbox/queue/2026-02-01-lancet-making-obesity-treatment-more-equitable.md b/inbox/queue/2026-02-01-lancet-making-obesity-treatment-more-equitable.md
index 0f4aaab50..ad6694958 100644
--- a/inbox/queue/2026-02-01-lancet-making-obesity-treatment-more-equitable.md
+++ b/inbox/queue/2026-02-01-lancet-making-obesity-treatment-more-equitable.md
@@ -7,9 +7,14 @@ date: 2026-02-01
 domain: health
 secondary_domains: []
 format: editorial-analysis
-status: unprocessed
+status: enrichment
 priority: medium
 tags: [obesity, equity, GLP-1, access, affordability, structural-barriers, population-health, belief-1, belief-2, belief-3]
+processed_by: vida
+processed_date: 2026-04-03
+enrichments_applied: ["glp1-access-inverted-by-cardiovascular-risk-creating-efficacy-translation-barrier.md", "lower-income-patients-show-higher-glp-1-discontinuation-rates-suggesting-affordability-not-just-clinical-factors-drive-persistence.md", "medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm.md"]
+extraction_model: "anthropic/claude-sonnet-4.5"
+extraction_notes: "pre-screen: 10 prior art claims from 5 themes"
 ---
 
 ## Content
@@ -46,3 +51,11 @@ The populations most likely to benefit from GLP-1 drugs (high cardiometabolic ri
 PRIMARY CONNECTION: ICER access gap; RGA timeline; Belief 2; Belief 3
 WHY ARCHIVED: Provides institutional framing (highest-prestige journal) for the GLP-1 equity problem. Pairs with ICER report for a high-credibility evidence base for the access inversion claim.
 EXTRACTION HINT: The access inversion claim (highest need = lowest access) gains from Lancet framing. Extractor should note the simultaneous CDC life expectancy record + Lancet equity concern as a telling juxtaposition for structural analysis.
+
+
+## Key Facts
+- The Lancet published equity-focused GLP-1 editorial in February 2026, same month CDC announced life expectancy record
+- WHO issued global GLP-1 guidelines December 2025 acknowledging equity and adherence concerns
+- Generic semaglutide competition expanding in India and parts of Europe (Dr. Reddy's launch)
+- US Medicare Part D maintains weight-loss exclusion for GLP-1 drugs
+- Obesity affects 40%+ of US adults