Compounded GLP-1s Are Under Fire Again: What Today’s Study Doesn’t Tell Us

A new study just hit PubMed that is already getting passed around as proof that compounded GLP-1 medications are unsafe. Fear travels fast. Context moves slower.

The study, published in Pubmed and available here, looked at compounded versions of semaglutide, tirzepatide, and liraglutide. Researchers looked at around 700 patients in the FAERS database and found higher rates of adverse events vs. branded forms, notably higher rates of improper dosing and hospitalizations. Over 80,000 reports exist in FAERS for GLP-1 medications, and even though 700 represents a very small sample of the total data available, some of what they found is real cause for concern.

The data is serious. It deserves attention. No one wins by pretending that compounded medications are perfect. But the way this study is already being weaponized, stripped of context and turned into a one sentence scare, tells you just as much about the ecosystem patients are trapped in as it does about the drugs themselves.

First, despite a lot of noise online, the study was not directly funded by Novo Nordisk, Eli Lilly, or any pharmaceutical company. The authors, affiliated with the Partnership for Safe Medicines, say they funded it through their own institutions. That organization does receive a portion of its funding from pharmaceutical companies, and that is an important fact to consider. Even so, this particular study was not pharma-sponsored. That distinction matters. It does not erase the outside pressures swirling around this space, but it does mean we should engage the data for what it is, not what we are afraid it might be.

At the same time, funding relationships do not automatically discredit important work. Groups like the Partnership for Safe Medicines, a nonprofit partially funded by pharmaceutical companies, have played a critical role in rooting out counterfeit medications and protecting patients. Good work can come from complicated places. We have covered some important stories even recently about counterfeit Ozempic in Arkansas pharmacies. We need someone watching our backs when it comes to safe and trustworthy medications. What matters is transparency, so that patients and providers can weigh information with eyes wide open.

The way the study presents its findings leaves gaps that matter. One massive gap in particular: there is no clear differentiation between products sourced from research grade (grey market non-prescribed, unfit for human consumption) peptides, 503A compounding pharmacies and 503B outsourcing facilities. These categories are not interchangeable. The study accepts the industry’s attempt to conflate all non-branded GLP-1 medications as the same. Hardly. Research grade products operate entirely outside of regulatory framework. 503A pharmacies operate under prescription law and are overseen by state boards. 503B facilities are required to meet Current Good Manufacturing Practices, a much higher FDA regulated standard.

Without clear sourcing breakdowns in the final data, the study leaves readers with the impression that all compounded GLP-1 medications pose similar risks. They do not. Some facilities adhere to strict quality standards. Others do not. That distinction is invisible in the final data.

For patients navigating the shortages, insurance denials, and soaring prices of branded medications, the stakes could not be higher. Many did not choose compounded versions out of preference but out of necessity. To frame the entire compounded space as reckless, without acknowledging the system that boxed patients into these decisions, is its own form of negligence.

There are risks with compounded medications. There are risks with ignoring the reality patients are living in, too.

Patients deserve clarity, not selective outrage.

We will keep tracking every piece of this story, and we will keep telling the truth, even when it is messy.

Subscribe to On The Pen for more updates. Just. Like. This.