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Cash-pay is standard

L., Pathmeswaran, A
Discrimination of site-specific alterations in gastrointestinal permeability in the rat

Eur Urol 1995
In contrast, the severity of neuropathic symptoms remained constant in the placebo group over the dosing period, whereas it significantly improved in the ARA 290 group (Figure 4B)

This is called off-label prescribing, and it's completely legal when the drug itself has FDA approval