NAD+, and the quiet lane it sits in.

What it is

NAD+ is nicotinamide adenine dinucleotide, a coenzyme present in every cell. In clinic settings it is compounded for injectable or infusion administration and sits in the longevity and metabolic category. Like everything else here it is a compounded preparation dispensed against a prescription, not an approved drug product.

Why operators treat it differently

NAD+ has occupied a comparatively stable regulatory position relative to the compounds that have moved between bulk-substance categories. That stability is the reason it often anchors a starter menu: it is less likely to disappear mid-quarter and strand a program built around it.

Stable is not the same as guaranteed. Regulatory status in this category changes, and a clinic should still avoid building economics that depend on any single compound.

Delivery format is the real operational question

Where NAD+ is offered as an in-clinic infusion, the constraint stops being inventory and becomes chair time. An infusion occupies a room and a staff member for a stretch, which changes throughput, pricing and how the service is packaged. Clinics that price it like an injectable and schedule it like an infusion tend to lose money on it.

Where it is offered as a subcutaneous preparation for at-home administration, the operational shape is closer to the rest of the menu: prescription, preparation, shipping, follow-up.

Menu fit

It sits naturally beside IV and recovery services a wellness centre or med spa already runs, which is why it frequently appears on the first version of a menu. Pricing and packaging for it are built during Days 1-30 against the delivery format the clinic actually intends to use.