The end of compounded GLP-1 drugs leaves many patients in a ‘lose-lose’ position
58 comments
·May 1, 2025psgdev
pogue
While you might be able to get the purity of the compound itself tested, the user buying it ready for injection or even homebrewing it themselves can still have serious sterility issues, heavy metals contaminates and other nasty leftovers in the batch itself from shady companies that sell these "peptides" and etc.
When a low quality lab in China is producing something that normally costs such a high amount there are always corners cut, quality issues and people manufacturing it that are not using the same quality control and standards you would even get from a compounding pharmacy.
Author William Llewellyn's talk on how the black market of anabolic steroids evolved over the years explains how things like this are made and what sort of contaminates get into gray/black market injectables (regardless of oil or water based).
Anabolic Steroids: an evolving black market (28mins) https://youtu.be/0LL7bL4F9G4
heavyset_go
> When a low quality lab in China is producing something that normally costs such a high amount there are always corners cut, quality issues and people manufacturing it that are not using the same quality control and standards you would even get from a compounding pharmacy.
The cost of GLP-1 drugs doesn't come from production costs or complexity, it is purely a function of being on patent.
A month's supply of Ozempic costs less than a dollar to produce. It costs $25k in the US because of patents.
psgdev
People regularly test black/gray market peptides in labs for both heavy metals and sterility (USP 61 or 71 I believe). The production of something like Testosterone/anabolic steroids is completely different has higher risks of contamination than peptides which use recombinant DNA or solid phase peptide synthesis.
That video is literally about anabolic steroids not peptides. Not to mention there was 0 testing labs in 2012 that users could send their items to, to get tested while there is many now a days. Back then in 2012 unless you had a friend at a University lab that knew analytical chemistry you were out of luck to get anything tested.
You aren't wrong about a lab in China cutting corners, having quality issues and low quality control standards but people don't care if they see 10,000+ people using peptides for decades without a single complaint about infection or real problems.
"is producing something that normally costs such a high amount" the cost has very little to do with the chemicals themself, the cost is about recouping R&D costs and having a 90% profit margin.
CuriouslyC
I suspect medical tourism is going to get a big boost from this. You can travel to someplace like Thailand or Taiwan and bring back a 90 day supply, and the savings covers your airfare with some leftovers. If you were going to take a vacation anyhow, it's a win-win.
HDThoreaun
You can order all this stuff on the internet. There are now three extremely popular medical drugs that are illegal or out of reach due to price here. Steroids, abortions, and GLP-1s are more than enough to set up clear net sites that deliver these drugs from Europe or China.
raincom
Become a compounded pharmacist yourself: get lyophilized powder of glp-1 drugs, bacteriostatic water, Leur Lock syringe with a needle, gloves and alcohol pads; make your own glp-1 compound in your home.
Meekro
I'm concerned about what would happen if everyone started trying to do this. How many would put themselves in the emergency room, or worse?
raincom
I see at least three sources of problems.
1. Test it for mass, purity, endotoxins, whether it is the real deal or not; this can be easily mitigated if one joins some testing group to share costs.
2. Calculate the dosage units properly, as it depends on how much bacteriostatic water is mixed with the powder. Here, many peptide calculators help. Some will end up making mistakes here; instead of taking 5 units, one will take 50 units--this leads to ER visits.
3. Hygiene: use gloves and alcohol wipes.
Meekro
Most people's understanding of basic math, and ability to precisely follow directions, is terrible. What's to prevent you from ending up with a concentration that's 10x or 100x what you intended?
ulrikrasmussen
How do you source powdered GLP-1 safely?
raincom
Sourcing is easy if you are adventurous. Many third party testing labs help you deal with safety: purity, toxins, whether it is legit.
pogue
Who is doing testing of these powders for toxins/heavy metals/purity/etc etc and what does that cost? Can you trust the results of said places performing these tests?
sneak
The same way we solve all of our problems: websites on the internet.
apwell23
half the pharmaceutical companies here in hyderabad seem to have shifted their production to glp drugs
feverzsj
Why would FDA do that? Obesity is the biggest public health disaster in US. They should make it as cheap as ibuprofen.
wyager
Do you want them to keep spending money on drug R&D to solve all the other problems that still exist?
feverzsj
No one says companies should lose money. The government can cover the price for everyone just like they did for covid vaccines. Considering obesity adds between $147 billion and $210 billion to annual U.S. health-care expenses[0], it would cost much less.
[0]: https://theweek.com/articles/870872/americas-deadly-obesity-...
oezi
My mathematical intuition says this isn't really much considering US annual GDP is 27 trillion (27,000 billions) USD. So less than 1% of GDP.
Your linked article says: Obesity adds between $147 billion and $210 billion to annual U.S. health-care expenses, increasing an average adult's medical costs by 42 percent — an estimated $200,000 over a lifetime.
Since annual GDP per person in the US is roughly 80k USD and average life expectancy is also roughly 80 so roughly 6.4m USD GDP per person lifetime. 200,000 USD over 6.4m would imply over 3% of GDP, which seems more reasonable.
morkalork
Careful, if you start framing the problem like that you might end up with socialized healthcare!
HDThoreaun
It isn’t a choice. Compounding is only legal when there is a federal shortage of the drug. When the shortage ends so does compounding. If the fda declares a shortage when there isn’t one they get sued.
TylerE
Because it’s under patent.
There was a temporary allowance for compounding it due to sustained manufacturer shortages but that is in the process of expiring.
digianarchist
Wasn’t GLP-1 discovered in 1984?
raincom
The first generation drug Exenatide's patent was filed in 1992, but got approved in 2005. The latest one is Tirzepatide, a dual agonist, approved in 2022. Expect soon for Retaglutide, a triple agnonist, in the market.
TylerE
Not the newer ones that have lower risks of lifetime digestive issues.
apwell23
hopefully to protect my investment in lily
foobarkey
Compounded: 200 USD month; Lilly/Novo Discounted: 350 USD month
Seems alright?
cubefox
The article and, indeed, its title, talk about "The end of compounded GLP-1 drugs".
cmckn
I’m regularly shown ads on Instagram for a company called “Willow”, which openly markets itself as a source of GLP-1’s for people who don’t meet the medical criteria. “I just want to lose 15 pounds before my beach vacation!” That type of thing. I’m not that upset to see the compounded GLP-1 market reigned in a bit.
DidYaWipe
FYI, it's "lose/lose."
anovikov
$350 a month is already almost as much as we pay in EU. It won't get any cheaper than that. Compounded GLP-1 drugs were an intellectual property theft - and not against some evil megacorporation, but impacting a company that actually already saved millions of lives and has capacity to improve lives of billions of people so much more. It could have been probably justified for a short while because of shortages (a logic of "as long as you are unable to satisfy our demand, we will copycat your product ourselves" is cynical, but with some moral stretch, acceptable), but not anymore.
raincom
It is $500 a month after the first month, as El Lilly charges $350 during the first month for a starter dosage.
ChemSpider
500 US$ = 442 euro. Does that include the higher doses? Than it is actually cheaper than in Europe.
15mg Zepbound is 489 euro in Germany for a month (4 shots).
raincom
$499 per month "[f]or the Zepbound 5 mg, 7.5 mg, and 10 mg vial" [1]. So, I don't know how much they charge for 15 mg.
firecall
Similar prices in AU$ here in Australia too. So around AU$300 to AU$400 for a months supply, or thereabouts. It varies - just going off my experience.
Hopefully the market will correct the pricing situation once the goldrush calms down.
Even my local pharmacist ranted about what a rort it is last time I asked LOL
sneak
You wouldn’t download an injection that makes you not fat…
I doubt you will find many here who agree with your usage of “theft” here.
haunter
Saxenda (from Novo Nordisk) is 180€ in Hungary for 36 days dosage
anovikov
Saxenda is a previous generation drug with efficiency below that of lifestyle changes/diets... Not at all what's being discussed here.
PostOnce
It's no moral stretch to say that if society pays tax to provide police and courts to enforce intellectual property rights for pharmaceuticals to encourage production of pharmaceuticals (note: not because of some "moral right" of a chemist), and you the pharma co don't hold up your end of the bargain (producing the pharmaceuticals), then we as a society need not hold up ours (enforcing the limited rights we granted you with our courts and police).
That seems like a straightforward deal. You provide us benefits, we provide you benefits. A one sided deal like you propose (we protect "your" medicine and yet get none ourselves) is the real moral stretch.
hansworst
The same goes for anything that provides value right? If you make some useful software, by that logic I should be allowed to copy it and use it in whatever way I see fit (including commercially), no matter what license you used?
PostOnce
If I refuse to make it available (commercially or otherwise)? Absolutely. Copyright exists to incentivize production and distribution.
I can see it argued that, being less critical than medicine, perhaps a book or software could be "out of print" for longer than medicine being out of production before the copyright protection ceases, but ultimately the only reason we have copyright to begin with is too encourage people to create and make available.
So yes, by all means. Make orphaned and out of production works publicly available.
anovikov
True (to some extent, there's always the other side), but now there's no longer a shortage. The drugs are there in the pharmacies. That's why compounding is outlawed.
cm2187
And honestly if you do a proper diet to lose serious weight, you are going to save much of that in food. If you are not doing a diet, then you have no business taking those products.
null
pogue
Anyone have the full article? It's paywalled with no easy bypass.
Scoundreller
drop the URL in here: https://search.google.com/test/rich-results
Click "View Tested Page" and you'll have the raw HTML at the right to copy into an html file and open (or drop the text heavy parts into an AI to remove the formatting). If you selected the Desktop view, open the image in a new tab.
pogue
Interesting! There is a link to access that in the Bypass Paywalls Clean extension, but I wasn't sure what that was for.
Can you suggest a prompt that would quickly strip all the HTML formatting from a file? There's a lot of broken characters for quotation marks and etc, but I was able to read it. Thanks!
rekabis
Radical idea:
Have the government step in and say, “if you want to sell your drugs in America, you can only sell them to me.”
Then the government hammers that price down as low as it can go, and buys in bulk. A small rider is added to everyone’s federal taxes - a few dollars at most - to pay for it all, and the drugs are provided for free with any prescription.
It’s called single-payer healthcare, and most any advanced country uses that method to turn a $2,000/mo drug that the end user would pay either directly or through income-reducing insurance, into a $50/mo drug that is paid indirectly through federal taxes at less than 1/100 the cost.
But nooooooo… America can’t do this because “socialism is evil”.
Most will simply go to the gray/black market.
A 2 year supply of Ozempic (Semaglutide) lyophilized in sterile vials is ~$120USD (300mg of Semaglutide, 2.4mg a week at max dose so 125 weeks) on the black/gray market and that's with at least 2 middlemen making a profit so realistically the cost might be closer to $70USD?. Anyone can pay to get it HPLC tested to confirm the quantity, purity, sterility etc not to mention people (bodybuilders) have been using gray market peptides for 10+years and you never hear any stories about something going wrong (Things go wrong with oil based steroids for bodybuilders commonly not peptides in BAC water).
Meanwhile that same ~$120USD 2 year supply of Ozempic is $8400 in Europe, $9600 in Canada and $24000 in the USA.