I see some people calculating the cost per pound lost. That seems silly to me. If this works long term, I plan to stay on it indefinitely - it's worth the investment for a better quality of life.
Just remember to drink lots of water and get enough fiber, especially if you're considering surgery. Constipation can be a real issue with these meds and after surgery. Better to prepare and avoid complications.
Compounding pharmacies are a tiny market compared to the big pharmaceutical companies. Big Pharma has a lot of influence. It's unlikely insurance coverage will change anytime soon.