You’re hitting a state licensing barrier, which is a lot less exciting than politics but way more real. Each state has different rules for what a 503A pharmacy can do for out-of-state orders. Some require in-state pharmacist approval on every order. Some won’t recognize another state’s credentials. Some have specific documentation requirements that cost money to maintain. It’s a regulatory patchwork, and Alabama’s one of the states that makes the compliance math harder. On the compounding side, when we consider a new state, it’s not yes or no. It’s: do we have the infrastructure, do we need a licensed consultant in-state, can we afford the overhead? Some states work. Others don’t. Telehealth operations look at that and decide it’s not worth the cost, so they exit the market for that state. Is it frustrating if you’re in Alabama? Yeah. Is it unique to your state? Not really - similar blocks exist in a bunch of other states too. Actual useful path: find a local 503A and ask which out-of-state compounders actually service your state. They’ll know the real workarounds better than any forum will.