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As you say, this is a nail in the coffin for Novo, it's not good for the underlying business

If you have commercial insurance, the manufacturer card may offer the lowest cost

Niacinamide 2% improves barrier strength and reduces inflammation within 6 weeks in split-scar studies

Use prebiotic fiber to feed the good bacteria and (if you are not in a mold and mycotoxin situation a little bit of good yeast (Saccharomyces boulardii) to begin to re-create a healthy gut microbiome

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That does not mean the medication is functioning like an anti-inflammatory drug in the same way a steroid or biologic might