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The same medications available through compound pharmacies or direct-pay programs like Hims, Hers, or Trump RX run at a fraction of what flows through a commercial PBM

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Yes, there are some bad apples out there, but you find them and go after them. While compounding pharmacies are primarily regulated at the state level, the FDA has the authority to conduct inspections of compounding facilities to monitor ongoing compliance or investigate a specific problem or product complaint that the agency has received