pete_manc_UK said:

LibrarianMeg said: ...my insurance denied cost and coverage coverage because...

I read this differently from pete_manc_UK, on substance rather than tone. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.

LibrarianMeg said:

Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…

LibrarianMeg said:

...compounded vs brand cost and coverage...

This debate comes up weekly and I think both sides have valid points:

Pro-brand: FDA-approved, manufacturing standards guaranteed, clinical trial data directly applicable

Pro-compounded: 10x cost savings, same active molecule, independent testing available, accessibility

My position: if you can afford brand or have insurance coverage, that's the gold standard. If not, properly tested compounded from a 503B pharmacy is a reasonable alternative. Neither side should shame the other.

COA_Karl said:

The affordability discussion here usually stops at individual tactics.

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

• Groceries: SAVED $231/month (eating less)
• Restaurants: SAVED $221/month (fewer meals out)
• Alcohol: SAVED $171/month (stopped drinking)
• Life insurance: Premium REDUCED by $41/month (lower BMI)
• Copays: SAVED $51/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.

One thing that is still open after MeganSA_TX’s answer:

Was that from a primary source or from a summary of one?

OP back with an update, since a thread like this is useless without one.

Update: approved on the third attempt after a peer-to-peer. Nothing about my case changed; only who was doing the talking.