Which telehealth services still offer compounded GLP-1s after the FDA crackdown?

It's important to start with a crucial disclaimer: The FDA has issued strong warnings regarding compounded GLP-1s (like semaglutide and tirzepatide). They state that compounded versions are not FDA-approved, are not interchangeable with brand-name drugs like Ozempic, Wegovy, Mounjaro, or Zepbound, and have not been evaluated for safety, efficacy, or quality. The FDA has specifically cautioned against the use of certain salt forms (like semaglutide sodium) in compounding, as these are different from the active ingredient in the approved drugs.

Given this "crackdown," many reputable telehealth services have either ceased offering compounded versions or have significantly tightened their criteria. Those that continue to offer them often do so with very specific disclaimers and rely on a medical necessity argument (e.g., in cases of brand-name drug shortages or specific patient intolerances).

Finding services that explicitly market and provide compounded GLP-1s after the FDA's increased scrutiny is challenging and requires careful diligence. Here are a few types of services that may still offer this, but you need to verify their current practices, ensure they are working with reputable compounding pharmacies, and understand all the risks:

1. Alpha Medical:

   • Why: Alpha Medical has historically been one of the telehealth platforms that offered compounded semaglutide (and potentially compounded tirzepatide) as part of their weight management program. They typically partner with licensed compounding pharmacies.
   • Caveat: Their offerings can change based on state regulations and ongoing FDA guidance. You would need to check their current program details and confirm if compounded options are available in your state.

2. Push Health / Sesame Care (Provider Marketplaces):

   • Why: These platforms connect you with individual licensed healthcare providers (doctors, nurse practitioners). Unlike a single service with a unified protocol, individual providers on these platforms may have different prescribing practices. Some providers may still be willing to prescribe compounded GLP-1s if they deem it medically appropriate for their patient and work with a specific compounding pharmacy they trust.
   • Caveat: You would need to specifically search for providers on these platforms who explicitly state they offer compounded GLP-1s for weight loss, and then have a detailed consultation to ensure they meet your needs and follow safe practices. The platform itself doesn't "offer" it; individual providers do.

3. Specialized Online Wellness/Weight Loss Clinics (often smaller or newer):

   • Why: A growing number of online clinics and "med spas" with telehealth components are emerging that focus on weight loss and may explicitly offer compounded semaglutide or tirzepatide. They often market themselves as more affordable alternatives to the brand-name drugs.
   • Caveat: This is where the highest level of caution is needed. You must thoroughly vet these services, confirm their providers are licensed, and verify the legitimacy and accreditation of the compounding pharmacies they use. Look for transparent pricing, clear information about the active ingredients (e.g., is it semaglutide base or semaglutide sodium?), and robust medical oversight.

Before committing to any service, consider the following:

• Transparency: Does the service clearly state the active ingredient being used (e.g., semaglutide base vs. semaglutide sodium)? The FDA's concerns often relate to the use of salt forms.
• Compounding Pharmacy Legitimacy: Ask for the name of the compounding pharmacy they use. Verify the pharmacy is licensed in your state and ideally accredited (e.g., through PCAB – Pharmacy Compounding Accreditation Board).
• Medical Oversight: Ensure you receive a thorough medical consultation, ongoing monitoring, and clear instructions for use and side effect management.
• Cost and Insurance: Compounded GLP-1s are typically not covered by insurance and are paid out-of-pocket.
• Risk vs. Reward: Weigh the potential cost savings against the unknown risks associated with non-FDA-approved compounded medications.

Given the dynamic regulatory environment, what's available today may change tomorrow. Always prioritize your safety and discuss all options thoroughly with a trusted healthcare professional.