Compounded Semaglutide and Tirzepatide Pricing After the 503B Exclusion (September 2026)
Compounded semaglutide runs $60-$279/mo and tirzepatide $90-$179/mo at 503A telehealth sellers in September 2026, vs $149-$449 branded. What is still legal.
Compounded semaglutide and tirzepatide did not disappear this summer, but the factories that made them in bulk are on their way out. On April 30, 2026, the FDA proposed to strike semaglutide, tirzepatide, and liraglutide from the 503B bulks list for good. A 503B facility is an FDA-registered outsourcing plant that compounds large batches with no patient's name attached. A 503A pharmacy is a state-licensed pharmacy that mixes one prescription for one patient. The proposal touches only 503B. Public comment closed July 30, 2026 after a 30-day extension. As of September 2, 2026, FDA has not published a final decision.
What is still legal is narrow. A 503A pharmacy may compound a copy of Wegovy or Zepbound only when a prescriber documents a change that makes a real difference for that patient, such as a dose the brand does not sell or an allergy to an ingredient. FDA said on April 1, 2026 that it will not act against a 503A pharmacy filling four or fewer such copies a month. A lower price does not count as a clinical reason. Many telehealth platforms still sell compounded GLP-1s under this rule. Some add vitamin B12 or use a different salt form to argue the product is not a copy. That has its own problem: a 2026 chemistry study found tirzepatide can bond with B12 to form a molecule that is not in the approved drug. See the B12 finding explained.
The price gap has narrowed. Compounded semaglutide at the platforms we checked on September 2, 2026 runs from $60 a month for medication at Mochi Health (plus a $79 membership) to $279 a month all-in at Noom. Compounded tirzepatide runs $90 to $179. Branded self-pay has come down to meet it. The Wegovy pen starts at $199 a month for two months, then $349. The Wegovy pill starts at $149. Zepbound vials cost $299 to $449 through LillyDirect. TrumpRx lists the Wegovy pen at $199 and Zepbound at $299. Hims & Hers, once the largest compounded seller, said on March 9, 2026 that it would stop offering compounded semaglutide. It now sells branded Wegovy under a Novo Nordisk agreement, and its gross margin fell to 64% from 76% a year earlier.
The safety record is why regulators moved. FDA had logged 990 adverse event reports for compounded semaglutide and more than 730 for compounded tirzepatide as of May 31, 2026. Many came from dosing errors with multi-dose vials. FDA sent 30 warning letters to telehealth companies on March 3, 2026 and 25 more in mid-June. STAT News reported on July 20 that LifeMD, a telehealth firm Novo Nordisk lists as a partner, pressed clinicians to review up to 25 cases an hour.
This guide covers what changed, what each platform charges today, how the branded prices compare, what to ask a 503A pharmacy before paying, and the warning signs. For the full branded picture, see GLP-1 Pricing: September 2026. For a longer checklist, see How to Evaluate a Compounding Pharmacy.
What changed: 503A vs 503B, the April 30 proposal, and what is still legal
A 503B outsourcing facility registers with FDA, gets FDA inspections, and can compound large batches without a patient's name. A 503A pharmacy holds a state board of pharmacy license and compounds one prescription at a time. FDA's April 30, 2026 proposal would bar 503B facilities from using bulk semaglutide, tirzepatide, or liraglutide, even in a future shortage. A 503A copy stays legal only when a prescriber documents a patient-specific clinical difference, and FDA has said it will not act against a pharmacy filling four or fewer such copies a month.
| Channel | Price | Source |
|---|---|---|
| FDA proposal to exclude semaglutide, tirzepatide, and liraglutide from the 503B bulks list | Proposed April 30, 2026 | FDA |
| Federal Register notice (docket 2026-08552) | Published May 1, 2026 | Federal Register |
| Comment period extension | Closed July 30, 2026 | Federal Register |
| Final determination | Not yet published | FDA |
| 503A 'essentially a copy' standard | Legal only with documented clinical difference | FDA Guidance |
| FDA 503A enforcement policy (April 1, 2026) | 4 or fewer copies per month tolerated | Foley & Lardner |
| Who oversees each pharmacy type | 503A: state board; 503B: FDA | FDA |
Compounded semaglutide: telehealth platform prices checked September 2, 2026
Prices below come from each platform's public pricing page on September 2, 2026. Most platforms split the bill into a membership fee and a medication charge, and a 'starting at' price applies to the lowest dose. Platforms change prices often, sometimes weekly, so treat this table as a snapshot. Hims & Hers, Ro, and LifeMD have moved to branded supply and appear in the branded section below.
| Channel | Price | Source |
|---|---|---|
| Mochi Health (compounded semaglutide injection) | $79/mo membership + medication from $60 | Mochi Health |
| Found (compounded semaglutide) | From $99/mo | Found |
| Ivím Health (compounded semaglutide) | $75/mo on 6-month plan + $75/mo membership | Ivím Health |
| Noom GLP-1Rx (compounded semaglutide) | $129 first month, then $279/mo | Noom |
| Henry Meds (compounded GLP-1 program) | From $179/mo | Henry Meds |
| Hims & Hers (compounded semaglutide) | Discontinued March 9, 2026 | PharmExec |
| GLP Chart price index (8 programs, membership + medication) | $149-$299/mo | GLP Chart |
Compounded tirzepatide: fewer sellers, higher floor
Compounded tirzepatide costs more than semaglutide at every platform that sells both, and fewer platforms carry it. Some pharmacies add vitamin B12 to the vial to argue the product is not a copy of Zepbound. A 2026 chemistry study found tirzepatide and B12 can bond into a new molecule that is not in the FDA-approved drug, so ask whether your vial contains anything besides tirzepatide.
| Channel | Price | Source |
|---|---|---|
| Mochi Health (compounded tirzepatide injection) | $79/mo membership + medication from $90 | Mochi Health |
| Found (compounded tirzepatide) | From $99/mo | Found |
| Ivím Health (compounded tirzepatide) | $133/mo on 6-month plan + $75/mo membership | Ivím Health |
| Henry Meds (compounded tirzepatide tablets) | From $179/mo | Henry Meds |
| Tirzepatide plus vitamin B12 additive | Ask before buying | Stanford Medicine |
| FDA adverse event reports (compounded tirzepatide) | 730+ reports | FDA |
Branded self-pay comparison: NovoCare, LillyDirect, TrumpRx, and the telehealth resellers
Branded prices have dropped far enough that compounded no longer wins by default. Novo Nordisk and Eli Lilly sell direct at fixed self-pay prices, TrumpRx lists the same drugs at government-negotiated prices, and Hims & Hers, Ro, and LifeMD resell branded pens and pills on top of a membership fee. List price (WAC, the manufacturer's published price before any discount) is still $1,349 for Wegovy, but almost no one pays it. Hims & Hers reported on August 10, 2026 that its gross margin fell to 64% from 76% after the move from compounded to branded GLP-1s, a measure of how much cheaper compounded product is to sell.
| Channel | Price | Source |
|---|---|---|
| Wegovy pen via NovoCare (self-pay) | $199/mo first 2 months, then $349/mo | Wegovy.com |
| Wegovy pill via NovoCare (self-pay) | $149/mo (1.5 mg); $199/mo (4 mg) | Wegovy.com |
| Zepbound vials and KwikPen via LillyDirect (self-pay) | $299-$449/mo | LillyDirect |
| TrumpRx (Wegovy pen, Wegovy pill, Ozempic, Zepbound) | $149-$299/mo | TrumpRx |
| Hims & Hers membership (branded Wegovy, Ozempic) | $39 first month, then $149/mo + medication from $149/mo | Yahoo Finance |
| LifeMD (branded Wegovy, Zepbound) | Wegovy from $199; Zepbound vial from $299 + $149/mo program | LifeMD |
| Ro Body membership (branded only) | $39 first month, then $149/mo (or $74/mo on annual prepay) | Ro |
What to ask a 503A pharmacy before you pay
The telehealth platform is the storefront; a separate pharmacy makes the drug. Get the pharmacy's name and state, then check it yourself. Ask for the certificate of analysis (COA), the lab report showing what is in your batch and at what purity, and ask who made the raw ingredient. A pharmacy that cannot answer these questions quickly is telling you something.
| Channel | Price | Source |
|---|---|---|
| Is the pharmacy licensed by your state board of pharmacy? | Free lookup | FDA BeSafeRx |
| Is it a 503A pharmacy or a 503B outsourcing facility? | Check FDA's registered list | FDA |
| Is the pharmacy PCAB accredited? | Optional, but a plus | ACHC / PCAB |
| What form of semaglutide is in the vial? | Base form only | FDA |
| Did your prescriber document why a copy is medically needed? | Required under 503A | FDA Guidance |
| Does the vial contain anything besides the GLP-1? | Ask about B12 and other additives | Stanford Medicine |
| Has FDA cited the pharmacy? | Free lookup | FDA |
Warning signs and regulator actions
FDA's warning letters target marketing that calls a compounded product 'generic,' claims it has the 'exact same active ingredient,' or implies FDA approval. State attorneys general have gone after med spas for the same claims. A July 2026 JAMA secret-shopper study and STAT's LifeMD investigation showed how thin the clinical screening can be at some telehealth sellers.
| Channel | Price | Source |
|---|---|---|
| FDA warning letters, telehealth GLP-1 marketing | 30 letters, March 3, 2026 | Foley & Lardner |
| FDA warning letters, second 2026 wave | 25 letters, week of June 15, 2026 | National Law Review |
| FDA adverse event reports | 990 semaglutide / 730+ tirzepatide | FDA |
| Ohio Attorney General letters to med spas | 14 med spas, April 2025 | National Law Review |
| JAMA secret-shopper study (Yale) | 45 of 49 sites prescribed | STAT News |
| STAT investigation of LifeMD | Up to 25 cases per hour | STAT News |
| Price too good to be true | FDA warning sign | FDA BeSafeRx |