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Cold chain storage, ordering practices, and the capacity of local pharmacies can create bottlenecks that leave patients unable to obtain their prescriptions even when supply appears sufficient on a national level

Insurance-covered brand can be cheaper but is also subject to formulary changes year over year

"Everybody knows that [the] injections are going to come off the shortage list eventually and patients need to be prepared for that," says Scott Brunner, the CEO of the Alliance for Pharmacy Compounding, the industry trade group