Of course you do!
Money is money and these medications cost a ton of it. The price tag on brand name Ozempic and Wegovy (semaglutide FDA indicated for diabetes and weight loss, respectively) is in the neighborhood of $1400-$1600/month. That's if you can get your hands on it. At present there's a massive nationwide shortage of these medications. The generic equivalent, on the other hand, is everywhere. And it's a fraction of the price. I'm sure you've seen generic semaglutide for sale online, you've seen it advertised at your local compounding pharmacy - you can basically get it anywhere. Is it all the same thing? Short answer: No.
Let's take a minute to talk about why you should care about where your semaglutide comes from.
Why Can Pharmacies Make Generic Semaglutide so Much Cheaper Than the Brand Name?
It basically costs nothing to make medication. The real question for drug manufacturers is the cost for years of research, development, and legalities involved in getting the patent for that medication. On average, a pharmaceutical company spends two BILLION dollars in bringing a new drug to market. My sympathy level is low here as Novo Nordisk is grossing about $300 billion in sales of Ozempic and Wegovy annually. Wegovy was approved by the FDA in June 2021, and its patent isn't scheduled to expire until 2032. That gives Novo Nordisk a solid 10 years of making serious bank on its sales of Wegovy - probably longer as most patents end up being granted extensions for some shady reason or other.
Is it Legal to Compound A Generic Version of A Medication While the Patent is Still Active?
Ah. This is a reallyyy murky area. Generic compounders don’t seem to care, however. This legal loophole is being capitalized on at scale. And trust me, Novo Nordisk is not happy about it. The patents on Ozempic and Wegovy protect them against generic manufacturers undermining their sales for the next 10 years - except in certain circumstances. When the demand for a drug surpasses its supply, the FDA allows patient specific compounds to be made so people can continue to take their medications. Because demand for Ozempic and Wegovy are so high, generic compounders are allowed to make 'semaglutide' due to the ongoing shortage. A shortage made worse by the likes of the Kardashians, Jessica Simpson, and what the hell happened to Sharon Osbourne? Someone get her a burger. For the love of God. The drug supply/demand exemption is being exploited here. So much so that local compounding pharmacies are advertising direct to consumers not only that they too have semaglutide, but what they're willing to sell it to you for. With your doctor's prescription, of course. My left eye twitch is back.
There are very strict rules around this kind of compounding. The FDA keeps close watch over all of it. What's happening right now is relatively unprecedented. The demand for Ozempic and Wegovy are so incredibly high, that regular pharmacies simply can’t keep them on shelves.
Enter, shady peptide compounding.
Look, making peptides is relatively straightforward. Literally anyone with an internet connection, a science degree, and a peptide synthesizer can do it. And, let me tell you, they’re doing it. In fact, the boom in generic compounding of semaglutide is simply crushing the FDA's ability to maintain appropriate oversight. What was once a niche subspecialty in the pharmaceutical industry morphed into a new full scale operation overnight. Semaglutide from Mexico, India, Lebanon – mostly mainland China. There used to be a handful of these compounders in my space. Now, they are literally everywhere.
Legitimate compounders have been around for a long time. It's a brutal business for a bunch of reasons. First, the FDA is up their rear end all the time doing audits. In order to participate in compounding for humans, pharmacies need to have a completely open-door policy with the regulators. It's a pain for them, but it's good news for you. When you order a compounded medication from an FDA regulated source, you can be sure it wasn't made by a college kid in his dorm room. It's sterile. It contains what it says it contains. No funny business-like MRSA or mercury. Well, that used to be the case. It took exactly one New York minute for capitalists to see the massive profit potential of making their own semaglutide and selling it to you - for less. Less than what? Less than all the compounders that have been doing this business under the harsh regulatory thumb of the FDA for years and years.
My Pharmacy Said They Have FDA Approved Semaglutide
That statement is 100% BS. The FDA has never approved semaglutide. They approved Ozempic and Wegovy, which contain semaglutide. Novo Nordisk is currently suing the pants off compounding pharmacies for making that very statement. They are not the same. You of course can argue the semantics of this, but none of that holds up in the land of patent law. They are also going after 'pop up' manufacturers of generic semaglutide. Even FDA registered compounding sources are being shut down left and right for poor manufacturing practices and making false claims about their products.
Can I Get A Script for Semaglutide From A Cheaper Pharmacy?
Sure, you can. But not from me. I know my peptide compounders. I’ve worked with them for years. They’ve worked with the FDA for years. I didn’t have to go their lab to make sure the employees washed their hands before returning to work after using the bathroom – the FDA did. As production of compounded semaglutide goes up, pricing from legitimate compounders will continue to come down. This is good. Unfortunately, the same market forces driving demand incentivize unscrupulous individuals and companies to purchase raw materials from less reputable sources as well as cut corners on sterility, potency, and purity.
Semaglutide is a powerful drug. Not all semaglutide is created equal. Understand that your local compounding pharmacy is not making semaglutide in the back – they’re buying it in bulk from somewhere else and selling it. I know this because I’ve asked – and to date, I don’t trust where it’s coming from. When was the last time you saw a sign at the pharmacy advertising a sale on Amoxicillin? A price comparison of blood pressure medication? How about ‘Buy two Zpaks, get one free!’ The sleezeball antics are embarrassing. If I wouldn’t take it myself, I’m certainly not recommending it for you. The small cost difference doesn’t justify the huge potential for harm. No one looks good in a bikini if they’re dead.
Stay safe friends. Medications containing semaglutide have done tremendous good. We just need to be mindful of responsible use and reliable sourcing. When demand for any product is this disproportionate to supply, we need to be extra cautious of ‘deals’. We usually get what we pay for. If the price sounds too good to be true, well, it probably is.
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All patients using (Ozempic, Wegovy, Mounjaro, Zepbound, semaglutide, or tirzepatide) should be having a DEXA bone scan and body composition completed annually. We want to make you are losing weight in a healthy way, keeping bones strong, and maintaining muscle mass.
Note: If you are using a GLP1, a DEXA/Body Composition scan will be discussed by your provider at your next visit. Any questions can be answered at that time.
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