This certificate is issued to
[Redacted — Self-Funded Employer, Southeast Region]
Governance Cycle 1 — Specialty Pharmacy Continuation
Period: Q1 2026 (90-day cycle) · Certificate ID: CGC-2026-SAMPLE
Population Summary
Outcome Distribution
Continue 40%
Adjust 25%
Taper 20%
Switch 15%
Continue: 782 (40%)
Adjust: 489 (25%)
Taper: 391 (20%)
Switch: 293 (15%)
Key Governance Metrics
60.0%
Reviewer Influence Rate
1,173 of 1,955 reviewed
40.0%
Documented Appropriateness Rate
782 confirmed appropriate
$4.8M
Governance Signal Value
TAF-weighted · directional
16:1
Cost-to-Signal Ratio
GSV per governance dollar
Governance Configuration
| Parameter |
Value |
| Governance Standard |
CGS v1.1 — all 7 triggers applied |
| Therapy Categories |
GLP-1 agonists, specialty biologics |
| Trigger Set |
DUR12, DOSE, LABGAP, COMORBID, NOOUT, BIOSIM, PA_BLIND |
| Reviewer Qualification |
PharmD (credentialed, independent) |
| Review Window |
Weeks 2–11 of cycle |
| Configuration Fingerprint |
v1.1-2026Q1-SHA256:9b4e...d827 |
Governance Narrative
This population presented a 25% flag rate across seven CGS v1.1 triggers. Duration-based flags (DUR12) accounted for the majority of initial identifications, consistent with measured patterns in prior governance cycles. The 60% RIR indicates that six in ten reviewed cases warranted a trajectory change recommendation. The 40% DAR confirms that four in ten continuation therapies were clinically appropriate after structured review. Both rates fall within the measured range observed across independent Cadence governance cycles (RIR 58–60%, DAR 40–42%).
The $4.8M governance signal value represents the TAF-weighted economic signal from 1,173 influenced cases. This is a directional measure, not a savings guarantee. It quantifies the economic magnitude of the clinical decisions that governance identified. What the organization does with the signal is a governance question, not an economic one.
Independence Attestation
This certificate was produced by an independent governance entity with no financial relationship to the pharmacy benefit manager, health plan, or provider network serving this population. Cadence does not participate in rebate arrangements, does not hold formulary authority, and does not benefit from the volume or price of the therapies under governance. The governing body is structurally independent. The findings are advisory.
Configuration Seal — Tamper Evident
SHA-256: 9b4e7c3a1f28d5e6a0b9c4d7e8f1a2b3c4d5e6f7a8b9c0d1e2f3a4b5c6d827
This hash represents the complete governance configuration used for this cycle.
Any change to triggers, thresholds, or review parameters produces a different fingerprint.
Certificate ID
CGC-2026-SAMPLE
Cycle Completed
March 31, 2026
Certified by Cadence, LLC — Governance Cycle Complete
This certificate attests that a structured continuation governance cycle was completed under the Cadence Governance Standard (CGS v1.1), with measured outcomes, an immutable audit trail, and independent clinical review.