Why did compounded GLP-1s become so widespread?
A drug shortage listing let compounders sell semaglutide for $150–300/month vs $1,000+ branded — at the 2024 peak, nearly 1 in 3 Americans taking a GLP-1 got it from a compounder — creating an unregulated parallel market critics blame on high branded prices.
Under federal law, compounding pharmacies can make copies of drugs listed as in shortage. Surging demand put semaglutide and tirzepatide on the FDA's shortage list from 2022, and compounders sold versions at roughly $150 to $300 a month versus more than $1,000 for branded products. At the 2024 peak, nearly one in three Americans taking a GLP-1 said they got it from a compounder. Doctors raised safety concerns, because compounded versions lack FDA approval and some contain additional ingredients or different chemical forms. For many patients without insurance coverage for obesity, however, compounded drugs were the only affordable option. Critics argue that high branded prices created the conditions for this unregulated market.