For the past couple of years, the demand for Novo Nordisk’s semaglutide-based medications Wegovy® and Ozempic® has far exceeded supply, leading to a nationwide shortage. To fill this gap, the FDA allowed compounding pharmacies to step in and offer compounded semaglutide, a custom version of the medication.
For many patients – especially those without insurance – these compounded versions of GLP-1 medications provided an accessible and affordable way to access treatment for weight loss and Type 2 diabetes. Brand-name versions can cost upwards of $1,300 per month out of pocket.
However, as of February 21, 2025, the FDA has officially declared that the Ozempic and Wegovy shortage has ended (for now). This means that compounded semaglutide products will eventually no longer be permitted under current regulations.
Here’s everything you need to know about compounded semaglutide availability, including manufacturing deadlines and prices for alternative medications.
1. When will compounded semaglutide no longer be available?
According to the FDA’s ruling, compounding pharmacies must stop manufacturing compounded semaglutide by May 22, 2025.
After this date, however, compounding pharmacies can continue to dispense the medication that they’ve produced until it expires. The shelf life of compounded semaglutide can vary depending on the manufacturing process, so it’s best to check with your pharmacy for specific shelf life information.
2. Is there any chance that compounded semaglutide stays available?
Yes, there’s a possibility that the situation could change. Currently, an ongoing lawsuit led by compounding pharmacies has the potential to delay enforcement of the FDA’s requirement that compounding pharmacies cease production of compounded semaglutide.
This means that, technically, compounding pharmacies could continue to produce compounded semaglutide while legal proceedings are occurring. However, this would put compounding pharmacies in a legally risky position. So even though there might be a delay in enforcing the halting of semaglutide production, availability is still uncertain and depends on how pharmacies respond to legal risks.
3. What if I want to start taking compounded semaglutide?
If you’ve never taken compounded semaglutide and are considering starting, access will become extremely limited after May 22, 2025 (pending any new legal developments), especially for new patients.
This is because starting treatment with GLP-1 medication requires titration, a process where your dosage is slowly increased each month until you reach your usual dose (called a maintenance dose). The titration process requires a steady supply of compounded semaglutide medication, and many healthcare providers will be hesitant to start patients on this medication given that the supply of this medication is unreliable.
If you do begin treatment with compounded semaglutide before May 22, 2025, be aware that it may be temporary and you’ll eventually need to transition to another medication or stop treatment altogether.
4. Are there any compounded semaglutide alternatives? How much do they cost?
Yes. Compounded semaglutide contains semaglutide, a type of GLP-1 agonist medication, and there are alternative medications that contain semaglutide or other GLP-1 agonists like tirzepatide and liraglutide. The price for these medications can vary greatly depending on your insurance status, whether or not it’s a brand name medication, and the pharmacy where you send your prescription.
Zepbound vials (tirzepatide): Zepbound vials contain the exact same formula and active ingredient as Zepbound. Unlike Zepbound pens (which are pre-filled with a needle inside), each Zepbound vial contains one dose of medication that is withdrawn from the vial using a syringe and then injected under the skin.
Zepbound single-dose vials are more affordable than Zepbound pre-filled pens, and are not available through insurance. This makes the vials an ideal option for people without insurance (or for those who don't have insurance coverage for Zepbound). The self-pay price for a month’s supply of 2.5 mg/0.5mL Zepbound vials is $349, while a month’s supply of 5.0mg/0.5mL Zepbound vials is $499.Wegovy (semaglutide): Wegovy is a weekly injection that is FDA-approved for weight loss. Wegovy costs $499 per month without insurance or medication savings cards. If you do have insurance, that cost could be as little as $25/mo. depending on your specific plan.
Ozempic (semaglutide): Ozempic is a weekly injectable medication that is approved by the FDA to control blood sugar levels in patients with type 2 diabetes and to treat chronic kidney disease in diabetic patients. However, it has been shown to be very effective in helping patients with overweight or obesity lose weight, and is sometimes prescribed off-label for weight loss.
Without insurance or savings cards, a month’s supply of Ozempic is listed at $997.58 by its manufacturer, Novo Nordisk. If your insurance does cover Ozempic, it may cost as little as $25/mo., depending on your insurance plan and pharmacy.Mounjaro (tirzepatide): Mounjaro is an injectable medication approved for the treatment of Type 2 diabetes and increasingly prescribed off-label for weight loss due to its potent dual action on both GLP-1 and GIP receptors. Without insurance, the monthly cost of Mounjaro is around $1,079. With insurance, patients may pay anywhere from $25 to $150 per month, depending on their coverage.
Zepbound (tirzepatide): Zepbound is a weekly injectable medication that is FDA-approved for weight loss. Without insurance, a month’s supply of 4 single-dose Zepbound pens is listed at $1,086.37 by Eli Lilly, the medication’s manufacturer. If you have health insurance, the amount you pay for your Zepbound prescription may be less, depending on your plan’s coverage.
Victoza (liraglutide): Victoza is a daily injectable medication used primarily to manage Type 2 diabetes by helping to regulate blood sugar levels. While not approved by the FDA for weight loss, it is sometimes prescribed for weight loss off-label. Without insurance, Victoza typically costs around $1,200 to $1,400 per month. With insurance coverage, patients might pay as little as $25/mo.
Saxenda (liralutide): Saxenda (liraglutide) is an injectable medication prescribed for chronic weight management in adults with obesity or overweight individuals with at least one weight-related condition. Like Victoza, it is a daily injection, but prescribed at a higher dose. The list price for Saxenda without insurance is around $1,350 per month. For those with insurance coverage, monthly costs may range from $25 to $200.
Generic liraglutide: This medication is a generic version of the brand name GLP-1 medication Victoza. It is a weekly injectable medication and is FDA-approved to treat Type 2 diabetes, but is sometimes prescribed off-label for weight loss like its brand-name counterpart. There is currently a shortage of generic liraglutide in the U.S., which means it may be difficult to access.
Without insurance, a month’s supply of generic liraglutide costs around $470/mo. For those who do have insurance coverage, it can cost as little as $25/mo.
There are also non-GLP-1 medications that are sometimes prescribed for weight loss, such as topiramate, metformin, and bupropion/naltrexone. Here’s a brief summary of how these medications work, along with their typical price tag with and without insurance:
Metformin (generic for Glucophage): Metformin is an oral medication that’s approved to treat Type 2 diabetes and is also used off-label for weight loss, particularly in individuals with insulin resistance or PCOS.
Without insurance, the monthly cost for generic metformin is around $34, making it one of the most affordable non-GLP-1 alternatives to compounded semaglutide. With insurance, metformin is often fully covered or costs under $10 per month, making it very accessible.Topiramate (generic for Topamax): Topiramate is a medication that’s commonly used to treat epilepsy and prevent migraines, but it’s also sometimes prescribed off-label for weight loss.
The monthly cost of topiramate without insurance typically ranges from $60 to $120, depending on the dosage. However, when covered by insurance, the out-of-pocket cost is often significantly lower (usually between $0 and $20 per month, especially when using the generic version).Bupropion/ naltrexone (Contrave): Contrave is a prescription medication approved for chronic weight management. The out-of-pocket cost for Contrave without insurance can range from $500-$600 per month depending on your pharmacy. If you do have insurance, your Contrave prescription may be partially or entirely covered depending on your plan.
I’m already taking compounded semaglutide – what should I do?
If you’re already taking compounded semaglutide, it’s important to talk to your healthcare provider as soon as possible to understand your options moving forward. They can help you determine your next steps or explore another treatment option before compounded semaglutide is phased out entirely. Planning ahead will help ensure a smoother transition and minimize disruptions to your treatment plan.
How does the end of the compounded semaglutide shortage affect Sesame patients?
Sesame’s mission is to make affordable, high-quality health care accessible to all, regardless of insurance status. As the availability of compounded semaglutide changes, we are actively working to expand treatment options for patients in an affordable, sustainable way.
Here’s what this means for you if you’re a Sesame patient who is currently taking compounded semaglutide as part of your weight loss treatment plan:
- As long as compounded semaglutide is produced under FDA allowances, we will permit it via Sesame.
- If you’d rather transition to a brand-name option, your provider will work closely with you to make that happen. We are already exploring ways to help patients access discounted versions of Wegovy, Ozempic, and other GLP-1 medications.
- We’ll work with you and your healthcare provider to secure longer-term compounded semaglutide prescriptions and arrange larger shipments, so you can stock up and maintain your treatment plan for as long as possible.
If you have any additional concerns about your medication or treatment plan, we encourage you to reach out to your provider with questions. Your provider can help guide you through your options, help you plan ahead, and ensure you remain on the most effective and affordable treatment.
