The demand for glucagon-like peptide-1 (GLP-1) medications for weight loss has surged, in part because there is a large population of patients who could potentially benefit from them. Meanwhile, advocates are concerned about the recent widespread distribution of compounded versions of the drugs. Since compounded versions often expect patients to measure doses from vials and use syringes for delivery—instead of premeasured autoinjector pens—compounded options can lead to dosing errors. But the advantage of compounded GLP1s is found in the cost. Approved branded versions of GLP-1s from major manufacturers may cost $1,000 or more per month, while compounded alternatives may cost just $200, making compounding an attractive business model for telehealth providers that have entered the market, according to a recent perspective in JAMA. An industry battle has ensued with some providers insisting that their compounded—and profitable—products are needed to fill supply gaps for patients. But the original brand manufacturers counter the assertion by insisting that their current supply of branded GLP-1s is now sufficient and no compounding sources are needed. Ultimately, the Food and Drug Administration (FDA) decides whether to declare a drug shortage, and it was a prevailing GLP-1 shortage that originally opened up the market for compounding in 2022. The shortage ultimately ended in December 2024, leaving providers on short notice to stop their compounding and switch to branded drugs. In general, licensed pharmacies must stop making most compounded versions of the GLP-1 semaglutide by April 22.
Urgent care’s weight loss business: In some markets, urgent care centers are offering weight loss programs, despite unproven demand within the urgent care setting and uncertainty about consumer behavior and preferences, according to Alan A. Ayers, MBA, MAcc, President of Urgent Care Consultants and Senior Editor of JUCM. “The business case for urgent care prescribing the branded GLP-1 medications is weak,” Ayers says. “Weight loss is typically considered part of prevention and wellness, which isn’t covered under many urgent care contracts. Prescribing the branded medication also creates a challenge for patients because the meds are not covered by many insurance plans and may cost $650 or more even with a manufacturer’s coupon. That’s why many urgent care centers create a cash-only side business of monthly visits that include compounded weight-loss medication. The ability to dispense and/or administer the medication is key to the success of these programs in urgent care.”