Others have already stopped sales, like Eden, which has created a special landing page declaring compounded tirzepatide to be “banned nationwide!” Ro, one of the most prominent telehealth companies in the space, has also stopped offering the product. “We are working to ensure our patients have the best options available to them to preserve continuity of care. We’ll follow the FDA’s guidance on compounding and all applicable laws and regulations,” says Ro spokesperson Nicholas Samonas. The company is still selling compounded semaglutide, as well as Zepbound and Wegovy. (It still lists Zepbound’s supply as “inconsistent” and Wegovy as in “shortage.”)
Other providers are explicitly telling patients to stock up on the medications. Telehealth clinic Emerge, for example, sent an email to patients noting that it was planning to offer longer-term prescriptions. “If the situation and pharmacy permits, we’ll offer the option to place orders for many months of tirzepatide,” it says. In the longer term, though, it notes that patients may need to switch to compounded semaglutide.
Meanwhile, a drug compounding industry group called the Outsourcing Facilities Association filed a lawsuit against the FDA on October 7, claiming that the drug remains in short supply.
When asked whether Eli Lilly is confident it has supply to accommodate compounded tirzepatide patients switching over to its products, Forbes sent the following statement via email: “All doses of Mounjaro and Zepbound—Lilly’s FDA-approved tirzepatide medications—have been available since early August. The FDA has confirmed that the shortage of Mounjaro and Zepbound is “Resolved” as communicated on FDA’s website.”
Whether or not it’s readily available, some patients believe price will continue to present an obstacle. This August, Eli Lilly announced that it would begin selling more affordable versions of Zepbound, with a month’s supply running between $400 and $550 depending on the dosage. Despite the introduction of this product, many people who have been taking compounded tirzepatide say they won’t be able to afford the name-brand version, even if it is readily available. “It is simply financially inaccessible,” Bertel says.
The FDA does not recommend taking compounded versions of GLP-1 medications and has advised potential patients about its concerns over dosing errors and adverse effects related to compounded semaglutide and tirzepatide. A variety of anti-obesity organizations have also warned against taking compounded GLP-1 meds, citing the lack of regulatory oversight. There are warranted concerns about whether bad actors within the compounding industry have put out inferior or unsafe products, and the industry certainly deserves careful scrutiny. But with so many people already taking compounded versions of these medications—and with such great reported success in many cases—this muddled and abrupt cessation has provoked its own health care crisis. “I’m not worried, I’m terrified,” says 71-year-old Ann Rezarch, who takes compounded tirzepatide for lipedema and says she cannot afford the name-brand meds. She calls revoking access now “inhumane.”
What’s more, with many compounded tirzepatide patients likely to shift to taking compounded semaglutide, it’s a crisis that may only get more intense when semaglutide, too, is removed from the FDA shortage list. (It is unclear when that will happen, but there is evidence it may not be far off: Novo Nordisk, which makes Wegovy and Ozempic using semaglutide, has recently increased supply of most dosages of the meds in the US.) The cost of drugs does not factor into whether they are in official shortage or not, but the affordability of these medications is directly connected to how accessible many patients find them. Without pushes to lower barriers further, the removal of compounded options from the market could lead to a rush toward counterfeit GLP-1s or research peptides. “It’s not acceptable to me that this is just going to stop,” says Rezarch. “This sounds corny, but it gave me hope.”
