Answering the narrow version, because the broad one does not have a single answer. The pattern that distinguishes a bad batch from an exit is behaviour rather than product. A bad batch comes with communication, a reshipment offer and a batch number. An exit comes with slower replies, pressure toward less reversible payment methods, sudden discounting, and the same reassurance repeated without any new information. The product tells you less than the correspondence does.

Dr.GastroMayo said:

The pattern that distinguishes a bad batch from an exit is behaviour rather than product.

Right, and one flattering data point from a group buy is not consistency. Consistency means separate batches, separately commissioned, over months.

PharmHunterJen said:

The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from…

Agreed, with a caveat about community reputation: it is a lagging indicator. Reports arrive weeks after orders, so a supplier can look excellent for a month after quality has already changed.

Correct me if the detail matters more than I have assumed.

Clinical perspective, offered as context rather than as advice.

Financial impact of cost and coverage weight loss beyond medication cost:

• Groceries: SAVED $232/month (eating less)
• Restaurants: SAVED $222/month (fewer meals out)
• Alcohol: SAVED $172/month (stopped drinking)
• Life insurance: Premium REDUCED by $42/month (lower BMI)
• Copays: SAVED $52/month (fewer BP/cholesterol meds)

Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.