mona_PHX said:

The pattern that distinguishes a bad batch from an exit is behaviour rather than product.

Vendor reputation tracking for vendor vetting: I maintain a personal spreadsheet with every order I've placed — date, vendor, batch number, Janoshik result, personal efficacy assessment (1-5 scale), and any issues.

After 20 orders across 5 vendors: average purity 97.0%, zero sterility concerns, 0 shipping issues (all resolved). This data gives me confidence in my current source and documentation if issues arise.

I encourage everyone to track their orders systematically. Community data aggregation makes us all safer.

A narrower follow-up, since the general answer is now clear:

What a vetting checklist should actually contain, as opposed to a list of things that are easy to fake?

Dr.PathRoch said:

Vendor reputation tracking for vendor vetting: I maintain a personal spreadsheet with every order I've placed — date, vendor, batch number, Janoshik…

There is a second half to this that has not been said yet. Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.

OP back with an update, since a thread like this is useless without one.

Went back through my own correspondence with an earlier supplier and the warning signs were all there in the replies, weeks before the quality changed. I was reading the product and not the behaviour.

Dr.BariatricHTX said:

Denials are usually procedural rather than clinical, and the order that works reflects that.

Agreed, with a caveat about community reputation: it is a lagging indicator. Reports arrive weeks after orders, so a supplier can look excellent for a month after quality has already changed.