This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally.
Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.
The correction was fair and I had been repeating something I had not checked carefully enough.
On post #30 — agreed on the reasoning, with one qualification.
Compounding pharmacies: pharmaceutical compounding of a drug not on the FDA shortage list is substantially constrained. The landscape changed when supply normalised. Current compounding availability is limited.
This follows post #32 rather than contradicting it.
Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.
Telehealth prescribing: widespread in the US and varying in quality. Models without a clinician reviewing measurements and history are not recommended by this community.
Picking up post #36: that is the part I would want checked first.
Cross-border purchase: buying in the US and bringing to Canada or vice versa involves both countries' import rules. The medication is legal but crossing borders with it is regulated.
Coming back to post #38, because the follow-up matters more than the original answer.
United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally.
I read post #39 twice before replying, because I had assumed the opposite.
Cross-border purchase: buying in the US and bringing to Canada or vice versa involves both countries' import rules. The medication is legal but crossing borders with it is regulated.
Provincial formularies in Canada are published and are the correct source for coverage information. Coverage for weight management is less common than for diabetes.
Two things before anyone answers the substance.
First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.
post #43 is right about the mechanism and I think understates the practical bit.
Regional variation in North America: access differs substantially by US state and Canadian province. Postcode is a major determinant of access.
Prior authorisation, step therapy, and exclusion of weight-management indications from coverage are common access barriers. The denial letter tells you which barrier you are facing.
Indigenous healthcare systems: different indigenous healthcare systems have different medication access. Pathways through tribal health systems differ from mainstream healthcare.
On post #43 — agreed on the reasoning, with one qualification.
Compounding pharmacies: pharmaceutical compounding of a drug not on the FDA shortage list is substantially constrained. The landscape changed when supply normalised. Current compounding availability is limited.
post #47 answers the question as asked. The question underneath it is different.
For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.
On post #48 — agreed on the reasoning, with one qualification.
Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.
For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.
post #54 is right about the mechanism and I think understates the practical bit.
Telehealth prescribing: widespread in the US and varying in quality. Models without a clinician reviewing measurements and history are not recommended by this community.
Worth separating two things that post #52 runs together.
Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.