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Job transitions and subsequent coverage changes (i.e., patient churn) or a transition to Medicare can create frictions that insurers have objected to in other high-cost treatment contexts, but the financial stakes are much larger for each use of CGT.[17] Median job tenures vary with age, with median tenures in the three- to five-year range for those under age 45.[18] This is not a new problem, but CGTs carry it to a new extreme by coupling high up-front price tags with the possibility of decades spent accruing future health benefits