Eli Lilly has sent cease-and-desist letters to hundreds of compounding pharmacies, telehealth companies, and medical spas making and selling “compounded” versions of tirzepatide. This hawkish legal strategy indicates that a new phase of the GLP-1 gold rush has begun—a crackdown against any entity selling non-name-brand medications.
Tirzepatide, the active ingredient in Eli Lilly’s diabetes drug Mounjaro and weight-loss medication Zepbound, was on the US Food and Drug Administration’s shortage list from December 2022 until October 2, 2024. When drugs in the US go into shortage, pharmacists, doctors, and licensed outsourcing facilities are permitted to “compound” copies to make sure patients have access to medicine they need. With so many potential patients eager to get on GLP-1 medications, the shortage of both tirzepatide and semaglutide (the active ingredient in Ozempic and Wegovy) left a huge opening in the market. Usually, pharmaceutical companies producing blockbuster drugs don’t have to worry about competition until their patents expire. But the shortages meant that it was legal for compounders to produce their own GLP-1 dupes—which they did, at an unprecedented volume. Major telehealth clinics jumped in to sell these products online at a fraction of the price of their name-brand counterparts. While there is no definitive accounting for how many patients are taking compounded GLP-1 meds, Alliance for Pharmacy Compounding CEO Scott Brunner tells WIRED that he estimates that the number is in the millions.
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