Postshortage Compounded GLP-1 RA Market in 2 States With Potentially High Demand.
This study highlights that 75 clinics are offering compounded GLP-1 RAs, but some facilities lack proper licensing, which raises safety concerns.
Where it sits
this study against the rest of the tirzepatide corpusSummary and findings
This study assessed the market for compounded glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in two states following shortages of semaglutide and tirzepatide. A total of 75 weight-loss clinics and medical spas were analyzed for their offerings and compounding practices. The findings indicate ongoing production of compounded GLP-1 RAs, including formulations with added ingredients.
Abstract
<h4>Importance</h4>Supply-side challenges combined with high costs and limited insurance coverage led to a robust market for compounded glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, assessment of this market since the end of the semaglutide and tirzepatide shortages is needed.<h4>Objective</h4>To characterize available compounded GLP-1 RA products, describe aspects of patient care and monitoring, and identify source pharmacies of available compounded products.<h4>Design, setting, and participants</h4>From August to October 2025, a cross-sectional secret shopper study was conducted of brick-and-mortar weight-loss clinics and medical spas advertising GLP-1 RAs for weight loss and offering compounded GLP-1 RAs. These businesses were identified in January 2025 using a web mapping application to perform location-based searches that were supplemented with a review of business websites and publicly available data regarding compounding facilities. The businesses were located in 2 states (West Virginia and Oklahoma) with potentially high demand for compounded GLP-1 RAs that were purposively selected based on obesity rate and insurance mix.<h4>Main outcomes and measures</h4>Compounded GLP-1 RAs offered by weight-loss clinics and medical spas; aspects of patient care and monitoring; and characteristics of compounding suppliers, including facility type, licensing status, objectionable conditions noted by investigators, and disciplinary actions.<h4>Results</h4>A total of 75 weight-loss clinics and medical spas offering compounded GLP-1 RAs were identified and included in the analysis. Of these businesses, 7 (9.3%) reported offering oral compounded GLP-1 RA formulations and 42 (56.0%) reported offering compounded GLP-1 RA products combined with B vitamins. Twenty-three compounding facilities were identified as suppliers, 4 (of 21; 19.0%) of which were not licensed to perform sterile compounding. Since 2023, 1 facility (4.3%) had received multiple US Food and Drug Administration warning letters and 3 of 22 (13.6%) had been subject to state-level disciplinary action.<h4>Conclusions and relevance</h4>Findings of this study show that, after the end of the semaglutide and tirzepatide shortages, compounding facilities have continued to manufacture GLP-1 RAs with added ingredients. Compounded GLP-1 RA sourcing is diverse but includes facilities without licenses to perform sterile compounding or that have been subject to recent disciplinary action, posing clinical and regulatory challenges.
Background
The paper addresses the market dynamics of compounded GLP-1 receptor agonists, particularly in the context of a shortage. Prior knowledge indicates that GLP-1 receptor agonists are important for managing certain metabolic conditions. Understanding market availability is crucial for healthcare providers and patients relying on these medications.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Key findings
- Not reported in abstract.
Limitations
- Not reported in abstract.