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As noted, Medicare Part D plans are not required to cover all other prescription drugs - but instead are only required to cover a fixed number of drugs in different therapeutic drug classes

doi: 10.1002/jms.745

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Mller-Stich BP, Achtsttter V, Diener MK, et al

By blocking this enzyme, the molecule preserves the cellular NAD+ pool, supports sirtuin activation, and stimulates energy expenditure through improved mitochondrial function

Unlike steroids, peptides are hydrophilic and bind to surface receptors such as G-protein-coupled receptors (GPCRs) to trigger internal signaling cascades without entering the cell nucleus