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Any decision to use bupropion and Saxenda together must be made under the direct supervision of a qualified healthcare professional who can assess the individual risk-benefit profile and provide appropriate clinical oversight throughout treatment

So insurers pay now and hope the pay-off sticks

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Sanyal AJ, Kaplan LM, Frias JP, Brouwers B, Wu Q, Thomas MK, Harris C, Schloot NC, Du Y, Mather KJ, Haupt A, Hartman ML (2024) Triple hormone receptor agonist retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial

Over a year, the difference between $1,000 per month brand-name and $300 per month compounded is $8,400