Anecdotally, some physicians are getting more comfortable prescribing compounded versions of popular weight loss drugs Wegovy and Zepound, which are both in short supply, NBC News reported Aug. 16.
"Not only are physicians more OK with prescribing compounded GLP-1 medications, but they are also advocating for them" amid cost and access issues, Shauna Levy, MD, an obesity medicine specialist and medical director of the Tulane Bariatric Center in New Orleans, told the news outlet.
Providers at Duke Health's Hillsborough Primary Care Center in North Carolina have also begun prescribing compounded versions of GLP-1s. One physician assistant at the practice told NBC News she has prescribed 10 patients compounded versions of the anti-obesity drugs since the state's health plan dropped new coverage for weight loss drugs earlier this year. When shortages end, Durham, N.C.-based Duke will switch back to prescribing only brand-name drugs, leaders said.
Drug compounding is nothing new, though it has received more attention with the rise of blockbuster weight loss drugs. During drug shortages, the FDA allows licensed compounding pharmacies to make versions that are in essence a copy of brand-name medications.
Compounding pharmacists typically purchase ingredients from FDA-registered facilities that produce copies of the active ingredients in brand-name drugs. However, the FDA does not test for the safety, efficacy or quality of the compounded drugs — the pharmacist does. Providers who prescribe compounded versions of the drugs should ensure they are working with pharmacies they trust, experts said.
Despite the practice seemingly becoming more common, many physicians remain skeptical.
"In my opinion, there are still too many unknowns about compounded versions of semaglutide and tirzepatide," Christopher McGowan, MD, a gastroenterologist who runs a weight loss clinic in North Carolina, told NBC News. "Regardless of whether a pharmacy is accredited or not, the actual compound is not monitored, regulated or tested by the FDA."
In July, the FDA warned healthcare providers of dosing errors associated with compounded versions of semaglutide, saying it received reports of hospitalizations and adverse events tied to the issue.
Novo Nordisk and Eli Lilly have filed multiple lawsuits against medical spas, weight loss clinics and pharmacies, accusing them of selling illegal versions that contain "impurities."