Jul 304 min read

GLP-1 Compounds: A Cheaper Alternative or a Risky Gamble?

Please note: In this article, we will refer to all medications as GLP-1s, following industry standards and consumer familiarity. Our clinicians prefer to classify these medications as incretin mimetics, which include drugs that act as GLP-1s, GLP-1/GIPs, and others.

Hand holding an injector pen — Photo by Canva

At this point, many of us have heard about GLP-1 agonist (glucagon-like peptide-1) medications and their effectiveness in managing type 2 diabetes and aiding weight loss. Medications like Ozempic, Mounjaro, and Trulicity work by mimicking the GLP-1 hormone, which increases insulin secretion, slows gastric emptying, and reduces appetite.¹ However, these benefits come with a high price tag, prompting some individuals to seek compounded versions.² While compounded alternatives may seem like the same medication at a fraction of the cost, they come with significant risks.³

Brand Name GLP-1 Medications

Brand name GLP-1 medications have undergone thorough testing to receive FDA-approval. These drugs are proven to be safe and effective for their intended uses. The most well-known GLP-1 medications include:

Approved for Diabetes:

Ozempic (semaglutide)⁴: Approved by the FDA for the treatment of type 2 diabetes. It helps manage blood sugar levels and has been noted for its additional benefit of promoting weight loss.
Trulicity (dulaglutide)⁵: A GLP-1 receptor agonist used to improve blood sugar control in adults with type 2 diabetes.
Mounjaro (tirzepatide)⁶: Approved by the FDA in 2022 for the management of type 2 diabetes.

Approved for Obesity:

Wegovy (semaglutide)⁷: Approved specifically for chronic weight management in adults with obesity or overweight conditions, alongside dietary and exercise changes.
Zepbound (tirzepatide)⁸: Approved only for weight management in adults with obesity.

A downside of these medications is their cost.² Brand name GLP-1 drugs can be expensive, and not all insurance plans cover them, leaving many patients searching for more affordable options.

The Appeal of Compounded GLP-1 Medications

Drug compounding is the process of combining, mixing, or altering ingredients to create customized medications for individuals.⁹ In the context of GLP-1 medications, compounding might involve creating a version of semaglutide, dulaglutide, or tirzepatide that is not commercially available or combining it with other ingredients.³

The appeal of compounded GLP-1 medications is their affordability and accessibility. Patients who cannot afford brand-name drugs or whose insurance does not cover them may explore compounding pharmacies as a more affordable alternative.

Risks and Considerations³,⁹

While compounded medications can offer some benefits, they also come with significant risks:

Lack of Regulation and Testing: Unlike brand-name medications, compounded drugs are not subject to the same testing and FDA approval process. This can lead to inconsistencies in drug efficacy and safety.
Potential for Contamination: Compounders do not always follow strict quality control measures as large pharmaceutical companies. This can increase the risk of contamination or incorrect dosages.
Variability in Effectiveness: Because compounded medications are custom-made, there can be variability in their dose strengths. Patients may not receive the precise dosage needed for optimal therapeutic effects.
Legal and Ethical Issues¹⁰: There have been some instances where compounded versions of medications are produced and sold in ways that violates patent laws or other regulations, putting both the compounder and the patient at risk.

Savings Strategies for GLP-1 Medications

Given the high price tag for many brand-name GLP-1 medications, it’s understandable why patients might seek out more affordable options. However, instead of taking a risk with compounded medications, there are safer ways to manage these expenses:

Manufacturer Assistance Programs¹¹: Many pharmaceutical companies offer financial assistance programs for their medications. For example, Novo Nordisk and Eli Lilly, the manufacturers of Ozempic, Wegovy, and Mounjaro, have programs to help reduce out-of-pocket costs for eligible patients.
Formulary Alternatives: Work with your pharmacist or healthcare provider to identify other medications on your insurance formulary. Sometimes, a slightly different GLP-1 medication is preferred over others on an insurance plan.
Diet and Exercise¹²: While medications play a crucial role in managing type 2 diabetes and obesity, lifestyle modifications such as a balanced diet and regular exercise can make a significant difference. Not only can health changes enhance the effectiveness of medications, but it can also reduce the necessary dosage. In addition, diet and exercise changes help to maintain weight loss long-term.

Conclusion

While the cost of GLP-1 medications can be overwhelming, exploring these alternative strategies can provide safe and effective ways to manage diabetes and obesity without resorting to compounded medications. By leveraging financial assistance programs, navigating insurance options, incorporating lifestyle changes, patients can find a safe approach to their treatment.