Futter’s provider, Henry Meds, no longer offers compounded tirzepatide injections, but allowed patients to place bulk orders before phasing it out. He went ahead and ordered several months’ worth of vials but doesn’t know what he’s going to do when he runs out. “I’m extremely nervous about what’s going to happen,” he says. “I’m eking every drop I can out of every vial to make it stretch a little bit longer.” (As of publication, Henry Meds is offering new and current patients the ability to bulk order 40 weeks of semaglutide injections. Henry Meds did not respond to a request for comment.)
Jim Bertel, a 41-year-old who lives in Colorado and credits tirzepatide for changing his life, was also able to stockpile his compounded GLP-1 medication before his provider stopped selling it. He’s unsure of what he’s going to do when he runs out later this month, and he is spending time scouring Reddit and Facebook forums to find which telehealth companies are still offering versions of the drugs. “Right now my plan is to take it month by month,” he says. “Hopping from provider to provider.”
Jessie, 40, who asked to be identified by her first name only, turned to a medical spa to get compounded medications when she couldn’t get consistent access through her insurance or primary care provider. Her provider initially wrote her a prescription for Wegovy, but she says it was “touch and go” getting it filled. She was able to supplement with a compounded version from the med spa when it wasn’t available. But at the end of last year, Jessie received a letter from her insurance company saying it would no longer cover Wegovy. Then her primary care provider stopped writing prescriptions for weight loss medications, saying they were too much of a hassle. She went back to the med spa and was able to get compounded semaglutide as recently as April, but the facility said it couldn’t guarantee supply moving forward. She’s now considering buying the drug from Mexico since she travels often to San Diego for work. “It’s the same meds, you don’t need a prescription, and it’s cheaper,” she says. In Mexico, brand-name Wegovy can be purchased for around $200 a month.
Spotty insurance coverage has helped drive demand for compounded GLP-1 products. Despite Wegovy and Zepbound being approved for patients with a body mass index of 30 or greater, and 27 or greater for those with at least one weight-related ailment, some insurance plans require a higher BMI or additional criteria for coverage—if they cover medications for obesity at all. “The whole underlying theme here is this stigma and bias of not recognizing obesity as a disease like we do cancer and diabetes and everything else,” says Florencia Halperin, an endocrinologist and chief medical officer at Form Health, an online medical weight loss clinic, “For cancer, you would never have an employer who says, ‘We’re not covering this.’”
Amanda Bonello, founder and CEO of the GLP-1 Collective, a nonprofit organization aiming to help patients access these medications, is not surprised at the lengths patients are going to. Bonello, who herself has taken compounded GLP-1 products, says for many patients she’s spoken to, the impact of these medications is not just about the weight itself.