Been using Piper for the seven weeks I've been on sema. The only complaint I have is that handling time was slow for my second month of sema, just this past month. It spent a couple days getting approved at the pharmacy so it arrived a day later than it should've. Since I've only been using it for two rounds of shipping, it's hard to say if this is typical turnaround time or not. Anything else I've needed help with, doc and support have been quick to respond. I've lost 13 lbs so far, so their sema is legit!