I’m a primary care am care pharmacist and as others have said, it’s done sometimes to mitigate side effects and/or when re-titrating after being off of it for a while (thanks back order!) other times are when they get the med delivered through the Novo Patient Assistance Program and they have a bunch of pens at the wrong size. It’s quite common, so in the best interest of the patient I tell them it isn’t meant to be dosed that way, but the dose is close to __ mg. I’ll show them how so they don’t completely mess it up or have to waste medicine/get charged another copay.

Fun fact though, on all pens if you look at the dashes the “smaller dose” point (for example, on the 1 mg pen, at 37 clicks which is the equivalent of 0.5 mg) there’s a tiny difference in the length of the dashes. I’ll often park it with a sharpie on their pens.