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Author Contributions Concept and design of study: KL Mahon, MJ Boyer, PL Molloy, LG Horvath, SJ Clark Data acquisition/analysis/interpretation: all authors

Pharmacy Network : According to ro.co, Ro operates Roman Health Pharmacy LLC and partners with additional pharmacies including LillyDirect (Eli Lilly's partner pharmacy) and NovoCare Pharmacy (Novo Nordisk's partner pharmacy) for specialized medication fulfillment, all operating in compliance with applicable state and federal pharmacy regulations

These challenges span technical and manufacturing issues, safety and toxicological uncertainties, as well as regulatory and consumer acceptance concerns (Figure 4)

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