On the subject in the title: Second pass at: Coverage in the US: a map of the usual obstacles Working notes rather than a conclusion.
Two things I would like separated before anyone answers on Coverage, because they get bundled and then argued about as one thing.
The first is descriptive: what has actually been observed, by whom, and how. The second is causal: why. I am asking about the first only.
Worth separating two things that the opening post runs together.
United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally.
Adding this to the thread rather than to the wiki, because I am not confident enough for the wiki.
Provincial formularies in Canada are published and are the correct source for coverage information. Coverage for weight management is less common than for diabetes.
Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.
Taking post #2 at face value and following it one step further.
Coverage decisions are made by individual payers and vary within the same jurisdiction. A denial from one says nothing about another.
I have deliberately not rounded that, because the rounding is where the argument starts.
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About the North America category
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