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Several factors combine: absence of active patent (thus little pharmaceutical incentive to finance trials), ambiguous regulatory status in most countries, high cost of a phase I to III clinical trial (several million to tens of million euros), difficulty in defining a precise indication acceptable to a regulatory authority

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A licensed healthcare provider reviews the intake and conducts a telehealth consultation to evaluate prescription eligibility

Manufacturer Assistance Programs Novo Nordisk and Eli Lilly offer patient savings cards and assistance programs for uninsured or underinsured patients