People who’ve been using more affordable copycat versions of Ozempic or Wegovy to lose weight will no longer have that option. Compounding pharmacies have been allowed to make compounded semaglutide — the active ingredient in the blockbuster drugs — due to a short supply of the brand name medications that started in 2022. “They are generally much more accessible — you can get them through telehealth pharmacies, med spas — and they’re much cheaper than the brand version,” NBC News medical contributor Dr. Natalie Azar said on TODAY. “(But) compounding pharmacies were never meant to be a substitute or be a competition. They’re sort of like alternatives when the patient can’t take the brand name.” People may consider compounded medications as generic versions of the drug, but the U.S. Food and Drug Administration says it doesn’t review compounded drugs for safety, effectiveness or quality so their usage “can be risky for patients.” Novo Nordisk, the pharmaceutical giant that makes Ozempic and Wegovy, emphasizes there is no generic semaglutide currently on the market. "Unapproved fake or illegitimate knockoffs expose patients to serious safety and efficacy risks," the company says in a statement to TODAY.com. A Novo Nordisk spokesperson points to a study the company funded describing quality issues it identified with compounded versions. The company has also nominated semaglutide to be included on FDA’s lists of drugs that show "demonstrable difficulties for compounding." Is compounded semaglutide going away? In February, the FDA declared the shortage of semaglutide to be over. It means smaller compounding pharmacies had until Tuesday, April 22, to stop making semaglutide. Larger compounding pharmacies have until May 22. The deadline has already passed for compounding pharmacies to stop making tirzepatide, the active ingredient in Mounjaro and Zepbound, which was also in short supply until the FDA deemed the shortage resolved in December 2024. All of the prescription drugs mimic GLP-1, a hormone the body produces after eating, which can decrease appetite and help the body manage insulin production. Patients self-inject them once a week, though a GLP-1 pill may be on the horizon. Mounjaro and Ozempic are approved to treat Type 2 diabetes. Zepbound and Wegovy are approved to treat obesity. The list price for the brand names is about $1,000 a month or more, while compounded versions can cost hundreds of dollars less. Are compounded GLP-1 still available? If you’re getting your medicine from a compounding pharmacy, you may no longer be able to. But there are a couple of workarounds that the compounding pharmacies might try to keep selling the copycat drugs, Azar noted. “For example, they may make different doses than are available by the brand. They may attach or combine, let’s say, a vitamin like B12, to the medicine, so it’s something that’s novel,” she said. “They’re not technically allowed to, but it’s also unclear how much the FDA will enforce this new regulation.” What to do if you rely on compounded weight-loss drugs There are other options if you can’t afford the brand name GLP-1 drugs, but people need to work with a weight loss doctor, Azar said. She offered this advice: Contact your compounding pharmacy to check if it’s still going to make the copycat version or if it’s totally stopping.Ask your doctor about older weight-loss drugs, including Saxenda, Contrave and Qsymia. They’re not right for everybody and have different side effects, Azar cautions, so they may not always be a good swap.Look into patient assistance programs offered by Novo Nordisk, which makes Ozempic and Wegovy; and Eli Lilly, the maker of Mounjaro and Zepbound. They may offer a copay card for people with health insurance or help with out-of-pocket costs for people without insurance, resulting in a lower cost.Consider bariatric surgery, which remains an option. Most people who discontinue a GLP-1 drug can expect to regain two-thirds of the weight they lost after a year, studies have found. But Azar said she's seen patients maintain some weight loss as long as they stick to healthy lifestyle changes such as moving their body throughout the day, eating whole foods and prioritizing protein in their diet.
