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

The landscape for compounded GLP-1s, especially after increased FDA scrutiny and warnings, is complex and rapidly evolving. It's crucial to understand that the FDA has specifically warned against compounded versions of semaglutide and tirzepatide that use unapproved "salt forms" (like semaglutide sodium or semaglutide acetate) and has emphasized that compounding should only occur when there's a clinical need and a drug is on the FDA's shortage list.

Many telehealth services have either ceased offering compounded versions or have become much more stringent in their criteria due to these concerns. However, some services still operate in this area, typically partnering with specific compounding pharmacies.

Here are some telehealth services that have been known to offer compounded GLP-1s, with important caveats:

1. Henry Meds:

   • Why: Henry Meds explicitly advertises and provides compounded semaglutide and tirzepatide through partner compounding pharmacies. They often highlight their pricing structure for these compounded medications. They aim to provide access to these treatments for weight management.

2. Mochi Health:

   • Why: Mochi Health focuses specifically on comprehensive obesity treatment. While they do prescribe branded GLP-1s, they have also partnered with compounding pharmacies to offer compounded semaglutide when clinically appropriate for patients, especially considering cost or availability issues of branded medications. They emphasize a holistic, medically supervised approach.

3. Push Health:

   • Why: Push Health is a platform where individual providers (doctors, nurse practitioners) can set up their practice. Many providers on Push Health have established relationships with compounding pharmacies and offer prescriptions for compounded GLP-1s directly to their patients. This platform offers more provider-level discretion.

Important Considerations and Warnings:

• FDA Warnings: The FDA has explicitly stated that compounded semaglutide and tirzepatide are not FDA-approved. They have also warned against using compounded versions that contain salt forms of these drugs (like semaglutide sodium or semaglutide acetate), as these are not the active ingredients used in the FDA-approved medications and have not been evaluated for safety or efficacy. Only the base form of semaglutide and tirzepatide is FDA-approved for use in compounded drugs under specific conditions (like a shortage).
• Legitimacy of Compounding Pharmacies: Ensure that any compounding pharmacy a telehealth service uses is licensed in your state, is PCAB (Pharmacy Compounding Accreditation Board) accredited, and adheres to strict quality and safety standards.
• Medical Supervision: Always ensure you receive proper medical evaluation, ongoing supervision, and support from a licensed healthcare provider who can monitor your progress, manage side effects, and adjust your treatment plan.
• Ingredient Sourcing: Inquire about where the active pharmaceutical ingredients (APIs) for the compounded medications are sourced. Reputable compounding pharmacies use APIs from FDA-registered facilities.
• Cost vs. Safety: While compounded medications are often significantly cheaper than branded versions, prioritize safety and efficacy over cost alone. Be wary of services that seem too good to be true.
• Evolving Landscape: The regulatory environment is constantly changing. What is offered today might not be available tomorrow, or the terms might change significantly.

Before committing to any service, thoroughly research their practices, the specific compounding pharmacies they partner with, and the qualifications of their medical staff. Always consult with your primary care physician about the best and safest treatment options for you.