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

It's important to preface this by saying that the landscape for compounded GLP-1s is constantly evolving due to FDA scrutiny. The FDA has issued strong warnings about the use of compounded semaglutide, particularly formulations using semaglutide salts (like semaglutide sodium or acetate), stating they are not approved and have not been evaluated for safety and effectiveness. They also emphasize that compounding is only permitted when there's an active shortage of the FDA-approved drug, and even then, only using the actual active pharmaceutical ingredient (semaglutide base).

That said, some telehealth services still work with compounding pharmacies to offer GLP-1s, often citing the high cost or intermittent shortages of brand-name versions. When considering these options, it's crucial to understand the risks and ensure transparency about the compounding pharmacy and the exact ingredients used.

Here are a few services that have been known to offer compounded GLP-1 options, but always proceed with extreme caution and thorough investigation:

1. Henry Meds:

   • Why: Henry Meds explicitly advertises compounded GLP-1 options (like semaglutide and tirzepatide) sourced from licensed compounding pharmacies. They often highlight their pricing structure as an alternative to expensive brand-name drugs. They typically emphasize their vetting process for partner pharmacies.

2. Mochi Health:

   • Why: Mochi Health is another telehealth platform focused on obesity treatment that has offered compounded GLP-1s. They work with patients to determine if compounded versions are appropriate based on factors like insurance coverage and medication availability, partnering with compounding pharmacies.

3. Push Health / Alpha Medical:

   • Why: These are platforms that connect you with independent healthcare providers. While the platforms themselves don't directly offer compounded drugs, individual providers on these platforms may choose to prescribe compounded GLP-1s through specific compounding pharmacies they partner with. This means availability can vary significantly depending on the individual provider you consult with. You would need to explicitly ask the provider about their stance on and ability to prescribe compounded versions.

Critical Considerations Before Pursuing Compounded GLP-1s:

• FDA Warnings: Compounded drugs are NOT FDA-approved. The FDA has specific concerns about the safety and efficacy of compounded semaglutide, especially when it's not the exact same active ingredient as the brand-name drug (e.g., using semaglutide salts instead of the base).
• Source of Compounding: Inquire about the specific compounding pharmacy used. Reputable compounding pharmacies (like 503B outsourcing facilities) are generally held to higher standards than 503A pharmacies, though both are allowed to compound for individual prescriptions.
• Ingredients: Ask exactly what active pharmaceutical ingredient is being used. Is it semaglutide base (the same as Ozempic/Wegovy) or a semaglutide salt? The FDA's warnings are particularly strong against the latter.
• Lack of Oversight: Compounded medications don't undergo the same rigorous testing for purity, potency, or adverse effects as FDA-approved drugs.
• Legality: The legality of compounding depends on specific circumstances (like drug shortages) and the active ingredient used. This can be a gray area that is subject to change.

Recommendation:

If you are considering GLP-1 medications, the safest and most recommended path is to pursue FDA-approved versions (Ozempic, Wegovy, Mounjaro, Zepbound) through a licensed healthcare provider. If cost or access is a barrier, discuss all options, including potential patient assistance programs or insurance appeals, with your doctor. If you still consider compounded versions, do so with extreme caution, thoroughly research the provider and pharmacy, and understand the inherent risks involved.