Call: Semaglutide and Tirzepatide: To Compound, or Not To Compound. That is the Question.
Posted: Mar 21 in Weight Loss Medication by Dr. Lazarus
Semaglutide has been FDA-approved for the treatment of type 2 diabetes in the forms of Ozempic and Rybelsus, and for the treatment of obesity in the form of Wegovy. Tirzepatide has been approved for the treatment of diabetes in the form of Mounjaro. However, many individuals do not have insurance coverage for these medications. We have heard reports of patients purchasing and injecting “compounded semaglutide” and “compounded tirzepatide.” Are these compounds safe? Are they effective?
Where does compounded semaglutide and tirzepatide come from?
Well, to keep this short, the answer is simple – I have absolutely no idea. The manufacturers of semaglutide and tirzepatide control 100% of their peptides, and they have not been made available for compounding. Therefore, we have no idea where the compounding pharmacies could be legally purchasing the ingredients. In addition, this is not the intent of allowing pharmacies to compound medications – usually this is done to improve flavor, remove an allergen, make a custom dose, etc. It is not intended to supply a readily available medication at a lower cost.
In a story on NBC News, a quote states: “”Jolley, who does not offer semaglutide, said it’s possible compounding pharmacists could be giving people semaglutide sodium, a cheaper and modified version of the compound that’s intended for research use only. Semaglutide sodium, however, isn’t approved by the FDA, he said, which would make selling the product illegal.”
Is compounded semaglutide really semaglutide?
The article further states that “Novo Nordisk, the sole manufacturer of Ozempic and Wegovy and the patent-holder of semaglutide, said in a statement that it does not provide the ingredient to these pharmacies, leading some experts to question where pharmacies are sourcing the drug — and whether it is semaglutide at all.”
Obesity is a serious and chronic disease associated with a loss of lifespan ranging from 6 – 8 years, associated with over 236 other diseases including 13 cancers. I have unfortunately lost many patients over the years to the disease of obesity. I took a medical oath to “first do no harm.” There is no way I can abide by this oath and offer a treatment that has no evidence for safety or efficacy, no oversight by the FDA, and where the source of the ingredients in unknown.
My advice, is just say no.
If you do not have insurance coverage but are interested in injectable GLP-1 weight loss medications, schedule a visit with Dr. Lazarus or Heather Thomas, PA-C, to discuss the most cost-effective ways in which these can be prescribed. Or, consider sticking with your oral medication, if it is reasonably effective for you. I do not believe it is worth the risk at this time to pursue compounded peptides for the treatment of obesity.
Can you please tell me what the cost is for Semeglutide and Monjaro?
Ozempic, Wegovy, and Mounjaro tend to run around $1,000 a month for cash-pay. If insurance is covering the medication, most of my patients pay more like $25 per month. Note that neither Ozempic nor Mounjaro will be paid for by insurance for purposes of chronic weight management. Only Wegovy and Saxenda are currently approved for weight management. I do have some creative ways I can prescribe Ozempic for my patients oftentimes lowering the cost to 1/2 or even 1/4 this amount.
I want a persecutor Tirzepatide for weight loss. My insurance will not cover it. Both my sister and daughter have had great success on Tirzepatide.
You would need to discuss this with your physician. Please note that the only genuine version of tirzepatide is Mounjaro. I recommend against using any compounded versions, as I do not believe there is a reliable and safe source for compounding (see FDA advisory here). The weight loss version of Mounjaro is expected to be announced in December (I hear December 8th is the big day!)