Legal Semaglutide Compounding Ends Today, So What’s Next?

The game is over. Today is the day legal semaglutide compounding at scale ends by decree from the FDA. Compounding pharmacies have known this day was coming since February when the agency determined that the shortage of semaglutide from Novo Nordisk was over. Well-informed patients who have depended upon compounding for affordable access to a GLP-1 like semaglutide knew this day was coming, too.

The real question now is: what comes next?

A Big Void to Fill

One thing is certain. This is a situation that will be very fluid. There is a big void to fill because although coverage of these life-changing medicines under health insurance has vastly improved, it is far from meeting the need. This is especially true for people with the greatest need and limited financial resources.

Many of them turned to compounding pharmacies because they could more nearly afford a price of $100 to $200 per month from compounders than stiffer list prices of more than a thousand. Even the cash price (~$500 per month) from direct-to-consumer programs more recently opened up by Lilly and Novo Nordisk was out of reach for many people.

If Novo and Lilly are smart (they are), they will find ways to reach many more of the patients who need their drugs. In other words, they will fill the void. But that will require a type of creativity and flexibility that is not typical for the pharmaceutical industry. It will also mean dealing with the pressure for lower prices.

Other Threats

We have some confidence they will figure it out. Because if they do not, the pressure on them will build even more. One dangerous source of such pressure might come from the dodgy online market for “research peptides.” These are products labeled as being unsuitable for human use, but often promoted with a wink and a nod to people desperate for an affordable supply of such medicines as semaglutide or tirzepatide.

Where compounded semaglutide or tirzepatide was once legal, selling “research peptides” to people for their personal use was never either legal or ethical. Make no mistake, this shadowy market is a threat to everyone. The best way to make it go away is to fill the void with legal and safe options.

Another threat is government pressure to bring prices for these products into a reasonable range. President Trump has already called out U.S. prices for these drugs as he announced his push for lower drug prices.

So clearly, as semaglutide compounding ends today, we will be seeing many more changes in the market for semaglutide and tirzepatide. We hope that the healthcare industry will put patients first as this unfolds.

Click here and here for more on the end of legal semaglutide compounding.

R.I.P. Compounded Semaglutide, illustration from OpenAI image generation

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May 22, 2025