If you've been on compounded semaglutide or tirzepatide, here's the short answer: yes, the shortage-era allowance for compounded semaglutide and tirzepatide injections has ended, and the FDA has proposed a further limit. (See our semaglutide guide.)
This is what happened, what it means for you as of mid-2026, and what you can do next.
What Changed
During the GLP-1 shortage of 2023 and 2024, the FDA let compounding pharmacies make copies of semaglutide and tirzepatide. A compounded drug is a custom-mixed version made by a pharmacy, not the sealed brand product. That made GLP-1 treatment cheaper and easier to get, often at a few hundred dollars a month instead of $1,000 or more. (See our tirzepatide guide.) (See our GLP-1 pricing guide.)
That window has closed. The shortage that made mass compounding legal is over, and the FDA ended its enforcement grace period. Here's the timeline:
- The grace period ended. For tirzepatide, the FDA first announced deadlines of February 18, 2025 for 503A pharmacies and March 19, 2025 for larger 503B outsourcing facilities. Court challenges followed. After the court ruled on March 5, 2025, the FDA said the 503A grace period had ended, and 503B facilities ran to March 19, 2025. Semaglutide followed a different clock. After a court ruling on April 24, 2025, the FDA said on April 28 that its 503A grace period had ended, and 503B facilities had until May 22, 2025.
- The FDA proposed a further limit. On April 30, 2026, it proposed excluding semaglutide, tirzepatide, and liraglutide from the 503B bulks list, the list of bulk ingredients that large outsourcing facilities may compound from.
What This Means for Patients
If you were relying on compounded semaglutide or tirzepatide: (See our telehealth GLP-1 providers.)
- The shortage-era allowance is over. This isn't a coming change. For semaglutide and tirzepatide injections, it ended in 2025. In April 2026 the FDA also proposed a further limit, which applies to large outsourcing facilities and is not yet final.
- Limited room remains for 503A pharmacies. A state-licensed 503A compounding pharmacy may still compound semaglutide or tirzepatide for one patient when the prescriber decides and documents that the compounded version contains a change that makes a significant difference for that patient. Separately, the FDA has said it does not currently intend to take action under the rule against regularly copying a commercially available drug, or copying it in inordinate amounts, when a pharmacy fills four or fewer prescriptions of such a copy in a calendar month. That is a choice about enforcement, not a legal exemption, and the other compounding requirements still apply (FDA guidance).
- Don't stockpile. Compounded peptides have shelf-life and storage limits, so hoarding is risky and wasteful.
- Have a backup plan now. Talk to your provider before your current supply runs out.
Your Options Going Forward
1. Switch to Brand-Name Medication
Brand-name Wegovy and Zepbound are easy to get now. The list price is steep (Wegovy lists at $1,349.02 for a month's package of 4 pens, and Zepbound at $499 to $1,086.37 per fill, by product and dose), but there are real ways to bring that down:
- Insurance and savings cards. If your plan covers weight loss, a manufacturer savings card can drop your cost to as little as $25 a month. See our insurance coverage guide.
- Self-pay programs. NovoCare offers the Wegovy pens for $349 a month and the Wegovy pill from $149. LillyDirect offers Zepbound for $299 to $699 per 28-day supply by dose, sold as a KwikPen or a 4-count vial. Neither one needs insurance.
- Medicare. Since July 1, 2026, the Medicare GLP-1 Bridge, a CMS demonstration running to December 31, 2027, covers Wegovy, the Zepbound KwikPen (not the vials) and Foundayo for obesity at a $50 copay for beneficiaries who meet its BMI-based criteria and do not have type 2 diabetes, moderate to severe obstructive sleep apnea or noncirrhotic MASH with moderate to advanced liver scarring (fibrosis). Standard Part D still excludes weight-loss-only use. See our Medicare coverage guide.
2. Explore the Oral GLP-1 Option
The oral semaglutide (Wegovy pill) was approved in December 2025 and launched in January 2026. It is now at many pharmacies. Your insurance may cover it differently than the shot, and the pricing works out better for some people. (See our GLP-1 insurance coverage guide.) (See our savings calculator.)
3. Ask About Other Medications
Other weight loss drugs are still available. Saxenda (liraglutide) is another GLP-1 option, and non-GLP-1 drugs like Contrave and Qsymia are prescribed at plenty of clinics. (See our liraglutide guide.)
4. Find a Clinic That Carries Multiple Options
What matters most right now is a provider who can shift your plan as costs and coverage change. Clinics that offer more than one medication, not just a single brand, are best set up to keep your treatment going without a gap.
How to Protect Yourself
A few rules for the new normal:
- Talk to your provider now. Get ahead of it instead of waiting to run out.
- Check your coverage. Brand-name and Medicare GLP-1 coverage have both expanded in 2026. Your plan may cover more than you'd guess.
- Be wary of miracle replacements. As compounded GLP-1s dry up, some sellers will push unproven peptides and supplements as substitutes. Stick with FDA-approved medications from licensed providers.
Find a Provider Who Can Help You Adjust
The GLP-1 market is changing fast. STAT News tracks the compounding rules and pricing in real time if you want to follow along. Your best move is to work with a provider who stays on top of the changes and can offer you more than one path forward.
Search our directory to find weight loss clinics with full GLP-1 programs, and browse clinics by state to find one near you. Filter by medication type to match a provider to what you need.