Compounded vs. Brand-Name GLP-1 Medications: What’s the Difference?

Published: 2025-04-09

Updated: 2025-04-10

4 mins

GLP-1 receptor agonists have been making waves in the world of diabetes management and weight loss. These medications work by mimicking a natural hormone that helps regulate blood sugar, curb appetite, and even slow digestion – making them an effective tool for people living with type 2 diabetes or obesity.

With the rising demand for GLP-1 medications like Ozempic^®, Wegovy^®, Zepbound^®, and more, compounded versions have started appearing through various telehealth companies and compounding pharmacies. However, many people aren’t familiar with what compounded semaglutide or tirzepatide medications actually are or how they differ from the branded versions. 

In this article, we’ll break down the differences between branded and compounded GLP-1 medications to help you make an informed decision about your health.

What are Branded GLP-1 Medications?

Branded GLP-1 receptor agonists are FDA-approved medications used to help regulate blood sugar levels and support weight management. They work by mimicking the GLP-1 hormone, which helps control appetite, slow digestion, and improve insulin response. These medications have been widely studied, with strong evidence supporting their effectiveness for people with type 2 diabetes and those looking to manage their weight. The most common GLP-1 medications contain either semaglutide or tirzepatide as their active ingredient. 

The brand-name semaglutide options include:

• Ozempic: FDA-approved for type 2 diabetes, though often prescribed off-label for weight loss

• Wegovy: A higher-dose version of semaglutide specifically FDA-approved for chronic weight management

• Rybelsus: The only oral form of semaglutide, FDA-approved for type 2 diabetes

The brand name tirzepatide options include:

• Mounjaro: FDA-approved for type 2 diabetes, though often prescribed off-label for weight loss

• Zepbound: FDA-approved for weight loss in qualifying patients

The brand name liraglutide options include:

• Saxenda: FDA-approved for chronic weight management

Zepbound is available in two forms: vials and pens. The Zepbound vial is a single-dose option for self-pay patients without insurance coverage, shipped directly to their door. The Zepbound pen contains the same medication in a prefilled, ready-to-use format. Just like the pricing model, the dosage options differ between the vial and pen, offering flexibility depending on the patient's needs.

What are the Pros and Cons of Branded GLP-1 Medications?

Pros

Branded GLP-1 medications undergo rigorous FDA-approval processes. This ensures they meet strict safety and efficacy standards. Large-scale clinical trials have demonstrated their ability to lower blood sugar, promote weight loss, and reduce the risk of cardiovascular complications in people with type 2 diabetes. Because these drugs are well-studied, healthcare providers can confidently prescribe them with a clear understanding of their benefits and potential side effects.

They are also manufactured under strict quality control regulations to ensure potency and effectiveness. Each dose is carefully formulated to deliver the correct amount of medication, reducing the risk of variability that can occur with compounded alternatives. Patients also have clear dosing guidelines based on their medical condition and treatment goals, making it easier to follow a structured regimen.

Due to their proven track record, branded GLP-1 medications are commonly prescribed for both type 2 diabetes management and chronic weight loss treatment. Doctors are familiar with how these drugs work and can tailor treatment plans based on individual needs. Many medical associations, including the American Diabetes Association (ADA), recognize these medications as an important part of diabetes care and obesity management.

Cons

One of the biggest barriers to accessing branded GLP-1 medications is their high price tag. Without insurance, these medications can cost hundreds to over a thousand dollars per month, making long-term use difficult for many patients. Even for those with insurance, coverage can vary, and out-of-pocket costs may still be significant.

Many insurance providers impose strict coverage requirements, such as prior authorization or proof that other treatments have failed before covering a GLP-1 prescription. In some cases, coverage may be limited based on BMI criteria, leaving some patients unable to obtain the medication through their insurance plan. This can lead to delays in treatment or force patients to pay out of pocket.

Additionally, high demand has caused widespread shortages of branded GLP-1 medications, particularly Wegovy and Ozempic, making it difficult for patients to consistently refill their prescriptions. When shortages occur, some people are forced to switch to a different medication or go without treatment temporarily. This unpredictability has also led to increased interest in compounded alternatives, as some telehealth companies and compounding pharmacies have started offering compounded versions of semaglutide and tirzepatide.

What are Compounded GLP-1s?

Compounded semaglutide and compounded tirzepatide are custom-made versions of these medications that are mixed and prepared by compounding pharmacies rather than being mass-produced by pharmaceutical manufacturers. 

Compounded medications are not FDA-approved, meaning they are not subject to the same quality control and safety testing as branded drugs. However, compounding is legal under specific conditions. Pharmacies are only allowed to compound a medication if there is a legitimate medical need – such as a drug shortage or a patient requiring a customized formulation. In the case of GLP-1 medications, this could include adjustments like adding B12 for potential energy support or modifying the formulation to help with nausea management, both of which are common and well-established practices in compounding.

Compounding pharmacies cannot legally compound exact copies of FDA-approved drugs when those drugs are commercially available.

Not all compounding pharmacies operate under the same quality standards. If considering compounded GLP-1 medications, it’s crucial to choose a licensed and accredited pharmacy that follows USP (United States Pharmacopeia) guidelines and maintains strict quality control. Patients should also consult with a healthcare provider before switching to a compounded version to ensure it is a safe and appropriate option for them.

What are the Pros and Cons of Compounded GLP-1s?

During shortages of branded semaglutide and tirzepatide, compounded options can provide continued access when prescribed by a healthcare provider. Compounded versions are often less expensive than branded GLP-1 medications, especially for those without insurance coverage. This being said, most insurance plans do not cover compounded GLP-1 medications, making them an out-of-pocket expense for patients. 

As previously mentioned, compounded medications don’t go through the same rigorous testing as branded versions, which means effectiveness and safety can vary. That’s why choosing a USP-compliant pharmacy is essential, as some may use unverified ingredients like semaglutide salts instead of the FDA-approved active ingredient.

How Can You Get Compounded GLP-1s?

With the FDA declaring an end to semaglutide and tirzepatide shortages, access to compounded versions is coming to a close. Compounding pharmacies that have been producing these medications under the shortage exemption must now phase them out, with strict deadlines in place.

• 503A (State-licensed) pharmacies must stop compounding semaglutide by April 22, 2025.

• 503B (Outsourcing facilities) must stop by May 22, 2025, or sooner if a court ruling speeds up the process.

While there’s a temporary enforcement discretion period, compounded GLP-1s will no longer be widely available. If you’ve been using a compounded version, it’s time to discuss next steps with your healthcare provider – whether that means switching to an FDA-approved medication or exploring other options for continued treatment.

Where Can I Learn More About GLP-1s?

If looking for help with reaching your weight loss goals, the Rex MD Weight Management Program can provide you with access to a licensed healthcare provider, brand-name GLP-1 medications approved for weight loss, metabolic testing, and more.

See if you qualify for the Rex MD Weight Management Program.