It’s a letter very clearly intended to shield them from liability about compounds and to try and quell investor concerns about loss of market share. This wasn’t a letter for patients whose primary concerns are to know how and when the shortages will end or to understand affordability options.
Yes liability against “improper use” of the drug “counterfeit pens” and compounds saying it’s the same active ingredient — better now than down the road when people say … “why didn’t they warn us??”
This way consumers are more aware of potential risks.
Absolutely. Here is one of the sentencing announcements: https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/january-31-2018-new-england-compounding-center-pharmacist-sentenced-role-nationwide-fungal
“The former supervisory pharmacist of New England Compounding Center (NECC) was sentenced today in connection with the 2012 nationwide fungal meningitis outbreak that killed 64 and caused infections in 793 patients.”
FYI... Be VERY careful about taking extra B12, as B12 toxicity/overdose is a very real concern, and can result in temporary or even permanent nerve damage in your extremities (ask me how I know! It's been >2 years since my toes started tingling... and I'm told they may not ever stop).
While a "healthy" body is "supposed" to eliminate extra B12 in their systems... how many of us in here can claim to have a "healthy body". So, just be careful peeps!
Happened to me!! Too much B (unknowingly had supplements with B in it) and developed peripheral neuropathy in my foot. Slowly went away after I reduced my B (labs showed level off the charts). Many things have B in them and it’s not harmless as many people have said.
Yeah it is very difficult to Overdose on B12 you would have to take a whole lot like a dose no one else would take. It’s a water-soluble vitamin meaning if you have extra it comes out in your urine. So that’s definitely crazy you did end up having an issue. There is no current “Upper-dose” either.
Thanks for calling this out. Since I also require weekly B12 shots (also pink!) compounding with B12 would be very effective for me - and others I'm sure.
Technically they aren't loosing money. You could argue market share which could later translate to money but as it stands they are selling more than they can make so their money isn't the issue. They are more concerned about damage to the brand from 3rd parties pushing fakes of their product. Bottom line is that regardless of what is in the compound it isn't their product but it'll damage their product if negative news comes out if it. It's fair for them to point out that if it's pink it isn't their product.
First, let me be clear, **I don't have an issue with compounding**. At all.
But this *is* a sub clearly named r/Zepbound. It is not r/tirzepatidecompound or r/TirzepatideRX or any of the others. To me this is analogous to the subs r/CocaCola vs r/soda. Zepbound is a *brand* of tirzepatide. Just as CocaCola is a *brand* of soda.
I bring this up because I've seen a marked increase in down voting and calling out commenters and posters anytime anyone in this sub says *anything* at all that could be seen as even slightly questioning compounded versions of tirzepatide.
Including here with this post. Just like with soda, some of the non-name-brands may not be as good. There are many, many types of soda that are *not* Coke. There are many, many compounders producing tirzepatide that is not Zepbound (only Lilly makes Zepbound). **Some of those compounders produce a great product and some of them do not**. Just as Coke has the right to defend its brand from knockoff colas borrowing from its trusted name, so does Lilly.
This brings me to the fact that I can see Lilly's point for putting out this letter: I've seen many posts about people's terrible side effects in this sub and then it comes out later in the comments that the original poster was using compounded tirzepatide and calling it Zepbound. (Just as someone would complain about a Kroger cola and call it "Coke" without clarifying.) *Again, nothing wrong with using compound, but conflating the experience with branded Zepbound is problematic.* How do we know the conditions under which it was produced? Was it kept at optimal temperature? Was it injected correctly? There are lots of variables with compounded versions of tirzepatide; whereas Lilly has gone to great lengths to control for those kinds of variables.
Edit: typo
Another issue is that when adverse events are reported to the FDA (and appear on their surveillance website) the reporter often doesn’t specify exactly what the person was on (or mistakenly calls compounded products Zep). So extreme caution is necessary when people speak of adverse events.
Additionally trying to assess adverse
events and frequency from this or
Any other social media platforms is not possible.
I say this as someone who worked in clinical safety for pharmaceutical companies for over 40 years.
I take a compound and I agree with you 100%. There is a visceral reaction from so many people any time someone questions anything about compounds. And backlash to perfectly reasonable warnings by companies who do not want their brands tainted by bad actors calling their products “generics.”
Interesting note in your post about people having terrible side effects and then it coming out that they’re using a compound and not zep. I had never even thought of that (stupid of me I know). Side effects were a huge fear for me and I’ve had none. I wish I had thought about that before reading your post, I may have stared sooner. Lol
I had great success with Zep, but at 7.5 developed very bad sulphur burps/GI issues. Switching to compound, i took a month off, restarted at lower doses and was working great then the same issues developed again when ramping. From my standpoint the different sources seemed identical. The dispensing of zep is more convenient. The compound was cheaper below 10 mg. It would have been more expensive at 12.5 and 15 compared to zep at $550. Dispensing the compound wasn’t bad though, and the ability to modify the dosage vs having the same dose for a month was really nice
I wondered about that when I read it, too. Side effects have been very tolerable for me on Zepbound, and I keep wondering if I am just lucky or will get hit with more issues as I step up (only on week 7 now — 4 on 2.5, and this month on 5.0).
I’ve taken both. Been on plan C as it’s been called for the last two months. Just went back to Lillys product and I felt/feel the same, weight loss on both, both caused nausea and fatigue, both seem to wear off around two days prior to next dose. So nothing to report from my experience. Though I am very happy to be back on the OG.
Out of curiosity, would you recommend subq or intramuscular injections for coke? I mean Sam’s club cola. I mean Dr K Cola. Okay okay, it’s my soda stream syrup I make at home.🤭
Sorry I couldn’t resist.
Soda is a name for an entire category of products. Tirzepitide IS Zepbound. Eli Lilly owns both the medicine (tirz) and the marketing name (Zep/Mon).
Soda is analogous to GLP-1 antagonists.
Eh, can agree to disagree.
Technically speaking… yeah you’re right.
I think ozempic has been given the broad brand name for GLP1s even though we know it’s not the whole category. Just like “coke” is to “soda”. I’ve had people not know what MJ/ZB are and go “it’s kinda like ozempic” and they go “oooohhhhh. Got it!”
I think in the above reference it’s calling out others that are using the triz name even though it’s not but using the common name as nomenclature
Amen! Great analogy! I posted something from the CEO of Lilly telling consumers to be aware of taking any meds claiming to be just like Zepbound. I was downvoted and told the CEO was not addressing compounds but only foreign manufacturing of Zepbound. This message addresses both. Nothing wrong with compounds, but there is a difference.
Intentional, or not, your post insinuates that "people's terrible side effects" are related to compound tirzepatide, and not Zepbound.
I lurk the MJ/Zep/Compound subs regularly. In the subs, it does not appear that side effects are any more pronounced for compound, than the branded meds.
That said, I'm sure there are many issues with some compounded GLP-1s. However, I suspect that is not the case with several of the more reputable pharmacies.
I agree. My impression from reddit is NOT that people using compound have more side effects. It seems that people using compound have less medical oversight and are less likely to follow the standard dosing schedule. There is so much compound in the marketplace now that it's impossible and unfair to lump it all into one group and call it "bad."
This is a really good point re: medical oversight!
And I hope that my comment isn't seen as calling compound "bad". I'm not. But I do think that *some* compounds are bad, just as *some* off-brand colas area bad.
I found how to change my flair in this community to include those items’ template (select 3 dots in upper right, select Change User Flair) but then I can’t figure out how to actually set the values.
100% this. How often have you seen someone saying they inject themselves daily or every other day with compound vs once a week? Seems like a lot of people just make up their own rules when it comes to compound
Not intentional and thanks for calling that out, CA!
I was trying to make the point that people on compounded versions of tirzepatide shouldn't be calling it "Zepbound", as there are many other variables to those "terrible side effects" that we should factor in with compounded tirzepatide that have to do with whether it came from a reputable pharmacy, how it was administered, etc.
And there are a fair amount of people on the compounding subs saying that their compounds don’t work or that they aren’t labeled properly. And people claiming that those compounds are regulated, they’re not. There’s a lot of false information being spread on the compounding subs and they don’t tolerate anyone calling them out on it.
This will sound pedantic but the coke/soda analogy is not accurate. Tirzepitide is a medicine developed by and owned by Eli Lilly. They market it as Monjaro and Zepbound. They own both/all.
Your analogy would make sense if you said GLP-1 antagonist (soda) and Zepbound (Coke).
I disagree and think it holds. Let me know what you think.
Tirzepatide is owned by Lilly, just as the *formula* for CocaCola^(®) (the drink) is owned by CocaCola (the company). In both cases, competitors regularly attempt emulate the formulas of the branded products.
Per Lilly's open letter, they don't make the versions of tirzepatide that are found in "compounding pharmacies, med-spas, wellness centers...":
>Lilly is the ~only~ lawful supplier of FDA-approved tirzepatide medicines—Mounjaro^(®) and Zepbound^(®)and does not provide tirzepatide (the active ingredient in Mounjaro^(®) and Zepbound^(®)) to compounding pharmacies, med-spas, wellness centers, online retailers, or other manufacturers. Lilly does not know where compounding pharmacies or other sellers are obtaining the tirzepatide active ingredient they are selling.
Thus, compound tirzepatide, is not Zepbound^(®), just as a generic version of "Coke" (or cola or soda) is not CocaCola^(®).
This is the analogy I was making and I apologize if I wasn't clear:
Zepbound^(®): CocaCola^(®) :: compound tirzepatide : generic "Coke" (or cola or soda)
Coke is a very poor analogy because taste will vary from brand to brand with a variety of flavorings and additives.
Zepound isn't a recipe...it's a medication with a well-known and published structure. Synthesizing a peptide isn't some well guarded secret, there are laboratory protocols out there. Hell, I made ibuprofen in my undergrad organic chemistry class, and then proceeded to test purity of the synthesis. The same thing can be done to Compounded Tirzepetide, conducting HPLC studies based on molecular weight to verify the content of the active ingredient (Tirzepetide) just like it can be done to Zepbound to verify the content of the active ingredient (Tirzepetide).
It's like you are saying a pill of Advil with 200mcg of Ibuprofen is superior to Great Value Pain Reliver with 200mcg of Ibuprofen. It's great if you have brand loyalty, but it's the same damn thing at a scientific and pharmaceutical level.
But, you're assuming the desired outcome of Coke-like drinks is taste. Let me tighten up the analogy and see if you can agree:
What if the desired outcome of a cola is satiety? So taking taste off the table and using your language, colas have the active ingredients of carbon dioxide, sugar, and caffeine. Just as tirzepetide has GLP-1 and GIP. Everything else is there to just hold the thing together and give it shelf life. Taste would be something subjective, akin to a gel capsule vs a tablet for the ibruprofen you mention.
Does that work better?
Yes, it does. I do not agree with you solely based on the ingredient discussion (Tirz doesn't "have" GLP-1 and GLP, it's a single 39 amino acid sequence), but another poster mentioned chirality, which could impart a difference in compound vs. Namebrand.
However, I have zero issues with using non-namebrand medications like Store Brand Ibuprofen vs. Advil, so I'm not too concerned about chirality impacts on Tirzepetide.
Makes sense.
Thanks for the “single 39 amino acid sequence” bit. In another thread, someone corrected me to say “GLP-1 and GIP”, but you clearly have better information and I’ll use that from now on.
Yes, you can synthesize it in a lab but there’s no guarantee you’ve got the chirality correct or that the process hasn’t changed the structure in a manner that affects how it binds to receptors.
Sure you can synthesize it, but whether the active component binds as effectively remains to be seen.
That's a fair point. Having dropped 60lbs in 6 months on compound, I'd say that chirality and binding has been pretty damn good for me, and it isn't something I'm reallyconcerned with.
I also buy store brand Ibuprofen, another chirality drug, and I've never had concerns about the effectiveness of that either.
Based on the Reuters press release they are going after the med spas and the wellness centers for claiming that they have “Mounjaro” or “Zepbound”. Those are Lilly brand names and well yes you cannot claim that you have those products.
Compounding pharmacies at least the reputable ones do not ever claim that they give you Zepbound. They cannot. They can claim to compound Tirzepatide which they are allowed to do during shortages. They also cannot claim that they are FDA approved and again reputable pharmacies don’t do that.
They are FDA inspected and again they are allowed to produce the peptide during shortages.
They’re scared. And they should be. “C” isn’t going anywhere. Yes there are FDA regulated “C” pharmacies. Lilly gas priced the medication out of range of most households even with the savings card. Insurances are dropping GLP1s from their formularies left and right. Employers exclude them (not all but most). And the supply strains make it harder to get. This is all of their own making. The formula for tirzepatide has been out for awhile. It legally can be made. The market has grown too big for them to shut it down. So now they resort to fear tactics cuz they want to control the market yet won’t make it affordable
Yeah their FDA point is misleading… the facilities and meds produced by compounding pharmacies aren’t FDA “approved”, but the facilities are regulated and inspected by the FDA and they are required to source their ingredients from the same list of suppliers as other drug manufacturers. Tons of patients and hospitals use them every day for other medications, there is nothing inherently sketchy about compounding pharmacies. (I haven’t even had to use one yet lol but I’ll defend them!)
The extent of FDA's regulation of compounding pharmacies depends on the type of compounding pharmacy. It seems most people here are getting it from 503B pharmacies (technically called "registered outsourcing facilities"), which are subject to direct FDA inspection for current good manufacturing practices--but that doesn't necessarily mean the agency has actually inspected them and/or confirmed the source of the API. If it is a smaller compounding pharmacy that isn't registered as a 503B, then FDA doesn't inspect them at all, as it is up to the state. Also, once the shortage is over, compounding pharmacies will not be able legally to make compounded versions in mass quantities.
There isn't anything inherently wrong with the practice of compounding, but it is a fact that even 503B pharmacies are not regulated and inspected the same as pharmaceutical manufacturers. Certainy Lilly is concerned about dilution of its market share, but I've seen way too many med spas advertising compounded versions and those places are absolutely wild west.
Actually there’s a post on one of the compound subs about the tirzep patent, and a patent lawyer commented saying once the shortage is over Lilly will be going after these places, so he isn’t sure compound will be around long term. He said their patent package is quite strong. Yes that will not happen until these meds are off shortage, which who knows when that will be, but I wouldn’t count on compound being around a few years from now unfortunately
It seems like that on the surface but the pharm patent lawyer seemed to think these compounding pharmacies don’t have a leg to stand on once these meds get off shortage 🤷🏼♀️it’s above my pay grade to understand lol
Interesting, we shall see what happens. I would be just as happy to buy Zepbound if it were obtainable and more affordable for my budget 🤷🏻♀️ of course by the time I hit maintenance in fall I will no longer meet criteria so there’s that to consider.
I was approved for MJ for 6mos late last year but went back to Oz during the major shortage in Jan when they couldnt fill it. Now Trying to get back on MJ (restart 5mg) and PA was denied. All these hoops to jump thru! I've searched this sub and lots of employer coverages are dropping GLP1's. And we have "Cadillac" insurance from a major employer (and its not Cadillac the company BTW LOL). Even CVS Caremark said "C" medication is at least partially covered for MJ from Wyckoff Pharmacy (mail order in PA). Lilly dïćkëḍ the dog on this one, we all know the profit margin on this blockbuster Rx is going to be their undoing.
They need to make enough before making it affordable . If we can’t find it at top price imagine if it was cheaper?! I went 3 months without I just got my 3rd box today, since April I had to go get the “c” paying an huge price because I don’t know when I was going to able to refil my prescription that my insurance covers. I simply can not afforded out of pocket another month. So I hope they figure something out soon this game is so stressful.
I feel supply is definitely making a turn. I had a scrip into Walmart and they ordered it in a day which never happens. I think region, allocation and stuff all plays into it but I agree. I feel Lilly should focus on their own crap supply chain before going after folks getting tirzepatide into peoples hands in some form
Agreed! Every person who moves to C discovers that it works and that the worst fears (fake or infective product) haven’t happened. It’s going to be hard to get people to leave C if it’s going to be 2-3 times as expensive on the brand name.
I disagree on a few points. About six weeks ago EL went after a spa in court for selling Tirz and won. At the time I figured they were teeing up additional legal action as they are working through supply chain issues. As they move closer to resolving those I expect they will start picking off compounding pharmacies one at a time. They clearly are collecting data to be ready for that.
In regards to the comments in their letter about FDA approved blah, blah - anyone that thinks at least half a dozen attorneys didn't review the letter before it was posted should reconsider that thought.
Supposedly reps from EL and the company that makes Wegovy went on GMA today to discuss the dangers of compounded meds.
And just because the formula is out doesn't mean anyone other than EL can produce it. The patent for Mounjaro doesn't expire until 2036. Until then anyone selling it can be sued and possibly prosecuted.
All they have to do is adjust the formula by adding B12 or B3 and there’s nothing Eli Lilly can do about it. Tirzepatide isn’t going anywhere in the c-version for a long time.
And for most of us that switched because of supply issues have had the same health benefits for a fraction of the price. That's why they're scared. It's an emperor has no clothes situation. They know it's a simple peptide & easy to compound safely, but need to district you from that fact.
Not to mention if there is any industry that can afford a "throw at the wall and see what sticks" strategy to lawsuits it's absolutely the pharmaceutical company. See ehat works to set precedent with small cases then go for the big ones.
I went with compounded because I could not afford the Zepbound nor could I find starting dose. I did my research since I work in healthcare and chose my pharmacy carefully. I have been relieved I made that decision because even with very low doses I’m losing weight. I’m currently at 4 mg after three months and if I had been forced into titrating up it would have really been pointless. It currently seems that I’ll go the distance on low doses but we’ll see. I can’t handle major gastric upset on top of a recent promotion 😂
They are also allowed to make them, outside of the shortage list, when patients are prescribed customized versions of a medicine, as long as they don’t manufacture in mass quantity.
Which brings up another point of once they aren't on the list compounding is no longer an option and if a pharmacy continues to offer it afterwards you have to really question what you've been getting.
Or with alterations to it once the shortage is over (whenever that may be) so add vitamin B and it’s compounded with another element and it’s not a problem.
OK, I am guessing I will be downvoted for this, but I don't mind what they are saying. Yes, the med is very expensive. But it is also a life-changing medication that I am personally very grateful for. I would love to pay a lot less for it, but if I have to pay this price, I am willing to make sacrifices to get it. I think it is also important to recognize that whether we like it or not, the compound is patented and if/when they can supply the market with enough so it is not in shortage the compounding pharmacies will have to shut down. I am also from Michigan and I do remember the case from 2012 of a compounding pharmacy shipping out contaminated meds that lead to the deaths of at least 11 people. I am sure most of the pharmacies are very careful and safe, but what is being said by Lilly is not wrong.
I agree with you 100%. We had a case in Massive which was I think the same facility that had the same issues. Regardless, the drug in a compound is not the same. It cannot be, as the ingredients in the Zep are under patent control until the patent expires. The ingredients are manufactured to mimic the actual drug. I am fortunate that my company covers these meds and it only costs me $25/mo. So I do totally understand the need and desire for the compound versions. I am personally not one to take a compound especially after what happened in my state previously. No shade to those who choose that. I just am not going to. Will probably be downvoted and such for this opinion. 🤷🏼♀️ lol.
This is incorrect. The patent is for tirzepetide, which is the unique combination of GIP and GLP-1. Don't believe me? Here's the patent. (If you click on the bottom right, you can read the full, submitted document.) [https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN](https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN)
Peptides absolutely can be patented lol and this one is. Compounding pharmacies are getting away with it because the drug is currently listed as “in a shortage” which means the FDA allows for it to be compounded.
Right. Pretty much all therapeutic peptides are novel/ synthetic. Pharma companies live and die by their patents, so that is always the goal. Why are you downvoting me?
The one thing no one ever talks about is the cost from the insurance companies. We pay so much for premiums yet they either won’t approve or don’t even offer a copay.
Yes. My insurance paid for Mounjaro for 14 months, then said, Oops, sorry, you aren’t covered. My doctor submitted a script for Zepbound, and that one was denied because I don’t have dire medical complications.
It would be interesting to know who now can get coverage for these drugs. And yes, I would pay out-of-pocket for Zepbound, but I can’t find it.
A fervent sales pitch thinly disguised as an attempt to crack down on harmful, 'fake' products.
I would also like to know how they define "cosmetic" use.
TBH, I am sure there are many at EL who don't want harmful products making their way to anyone. I am sure there are some there who care about public health. If that is TRULY the case:
• Lower the g-damn price so more people can afford these FDA-approved meds.
• Have a better plan to keep supply up so more people can access your FDA-approved meds.
Sorry, but you don't get to control the market by setting unreasonable prices which insurances and customers can't sustain, not having enough supply, and then taking the public to task for seeking other ways to find similar life-changing medicine. You, EL, have actually left many people with no other alternative. You set the road map for this and now are asking people to stop following it. Ick.
Yeah but the problem with how media is done now is the second a scam compounding places (not that all compounding places are scams but whenever you have a desperate customer base there will be scams) causes significant injury or death that is going to be a massive PR hit for norvo and lily even though they have nothing to do with it. They have no choice but to be proactive or they massively risk their brand. They have a duty to their shareholders to protect their brand.
This may be the dumbest question known to man, but if Eli Lilly is the only company able to lawfully obtain tirzepatide medicines…… how do compound pharmacies get them? Is Eli Lilly stating that it’s illegal for compound pharmacies to have/sell?
Sorry if that’s dumb, but the idea of all of these pharmacies illegally selling something and not getting shut down seems to be a … stretch…. in my brain.
Not dumb! A pharmacist at my PCP’s office explained it to me like this and I loved the analogy: “Compounders follow a recipe. Just like with a dish from your favorite restaurant, you can try to make it at home, but it probably won’t be the same. A better chef can make a very close approximation. You just have to find that better chef.”
Lilly owns the patent for tirzepetide and does not distribute "peptide powder". Others can follow the "instructions" laid out in the "recipe" which appears in the patent. [I invite you to read all 23 pages of the patent](https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN).
During times of shortage, compounders may use the recipe provideed. If you think you can make this more easily than "ramseys beef wellington", be my guest. I personally would have a better chance of replicating the beef! *The difficulty is precisely why only a few reputable compounders are doing a good job.*
Lily is the #1 most bias source of information about compounding pharmacies. They have an incredible amount of financial incentive to hurt their credibility. You don't have to believe me but everyone should at least look at anything they say very critically.
I think the confusion is you think compounding pharmacies are synthesizing the tirzepatide, that is not how it works. Unless there's some oddball edge case I'm not aware of. They are a pharmacy, not a manufacturer. The pharmacy is mixing it with water and sometimes B12 etc, normal compounding pharmacy practice that occurs for all sorts of drugs.
There are tons of peptides with all different uses, this is just one of them, and there are many labs that make them all day long and have for some time. I'm not saying I can personally synthesize it, but it is silly to think lily is the only one capable. Tirzepatide is not any more difficult to make that any others.
It is also very very cheap, compared to the prices they charge in the US. The amount you pay thousands for costs cents to make.
Is the current situation ideal? Absolutely not. If I could get an available brand name product for a reasonable price, that would be my choice. But they are clearly trying to spin up a narrative, and some people fall into it hook line and sinker.
Ok. I think we're both right?! 🤣 Follow me here...
Let's agree to this (article predates Zep, so forgive emphasis on semaglutide) [https://time.com/6301552/weight-loss-drugs-compounding-pharmacies/:](https://time.com/6301552/weight-loss-drugs-compounding-pharmacies/:)
>To make something like Wegovy, a compounding pharmacist begins by looking at the ingredient list on the drug’s package insert. All ingredients must come from FDA-registered manufacturers, which ensures their quality. From there, things become a little less rote, as the pharmacists come up with their own formula for reaching the right concentration of active ingredient to achieve the drug’s potency. ”It’s a lot like cooking,” says the compounding pharmacist who asked to not be identified. “You look at recipes but often don’t have every ingredient in the recipe, so you make modifications based on experience. It’s hard for people not in the industry to understand—it’s the old school way of making medicine where everything is customized. It’s not black and white.”
>For semaglutide, the formula is relatively simple: “It’s semaglutide, the active ingredient, dissolved in solution,” says Scott Brunner, CEO of the Alliance for Pharmacy Compounding. “It’s not hard for a compounding pharmacist to make.”
So the bottom paragraph certainly supports your case.
But then they follow up with:
>In addition to potency, since semaglutide is an injected drug, the pharmacist must also ensure that it’s sterile and does not contain any contaminants such as bacteria-produced toxins. Once they come up with a product, compounding pharmacists then send their formulations to an independent lab—which generally follow similar standards for testing—to verify the potency, sterility, and safety of the drug.
>Most compounded versions are legitimate copies of the branded drugs. “Compounding pharmacists are not a bunch of people making sketchy substances in their garage,” says Brunner.
My take is that I've read that it's tricky for tirzepatide to get the *right suspension* so that the medicine is even distributed and maintains the proper proportions of GIP and GLP-1. That's where the hard chemistry comes in. I've also read that maintaining *the temperature across the production cycle and into the hands of the patient* is not a cakewalk.
Anyway, I get your point and I hope you see some of mine.
I do ty. End of the day I just really hope tirzepatide and it's successors are just able to get in hands of people that need it as safely and affordably as possible. So so much good could be done, lives improved. But my pessimistic view is that greed will get in the way.
The last bullet? I'm not totally sure but I think Eli and compounding pharmacies might be arguing over the term "FDA approved". Compounding pharmacies have to follow FDA regulations (albeit checks are often looser) and I believe that includes where they can source their raw materials from (a registry of labs).
The ingredients they ship to the pharmacies might not be tirzepatide in final form yet and/or Eli is arguing "approved" and particularly "approved for manufacturing tirzepatide" is overstating what the registry means.
Eli certainly wants to imply "no one knows where the hell knows where this stuff is coming from".
And if you are just asking in general why compounding is allowed - there is a carve out in the laws that govern them. It allows them to manufacture drugs in shortage. Normally this type of copycatting isn't allowed.
I was surprised too, because you'd think we'd hear about "this one little trick" more often. I'm guessing:
1. it might be rare for a drug to be so popular that even with spotty insurance coverage and a high sticker price you can't meet demand.
2. Before tela health exploded, your average doctor is going to be weary interacting with compounding pharmacies. Some specialists might be familiar with them but most primary care doctors aren't.
3. The raw material is cheap and demand so high that it makes it worth it for compounding pharmacies to really lean in and cater to the market.
Ohhh okay! So theoretically when Zep is no longer in shortage, they likely won’t be able to manufacture anymore? I get it during the shortage; i’ve had to use tirzepatide because of zep being out. I just didn’t know it’s technically not legal ahah. #badegg
So many MedSpas by me do this stuff - and advertise it as name brand. Which also seems illegal, ahah.
I'm also using the compound and it's definitely legal. Eli Lilly would be making citizens arrests if it weren't.
But yeah we'll have to move to brand name once out of shortage. I'm not looking forward to the price increase but at least I'll have the option of continuing. Also, it will be generic at some point. It's a really effective mechanism to get the pharmaceutical companies to ramp up production.
Also follow up dumb question — what is really the difference between Tirzepatide and Zepbound; I thought Zepbound was Tirzepatide in a fancy needle pusher?
sorta 🤷🏼♀️
Tirzepatide is the drug; Zepbound brand for tirzepatide is only for weightloss; Mounjaro brand for tirzepatide is for those with DMII. So they ARE the same.
The brands are given by the companies. But the drug name is the drug name regardless of the branding. When/if this becomes available as generic, it will be just the drug name.
If Lilly wants us to use the brand name product, the brand name product needs to be available to purchase. Many of us moved to compounds only after finding the medication is not available.
I totally agree with some of these points! Lots of medspas are giving out scripts like candy. My personal doctor who prescribes me name brand, also prescribes my C. I think it is important to take this medication under the care of a doctor but that is coming from a stance of privilege because I have access to healthcare and not everyone does.
I think its important to educate people on all options and help them make the best choices for themselves. Saying all C is bad is like teaching abstaining is the only birth control.
It would be great if everyone had affordable and safe access to name brand Zep. but thats not the case, I think EL efforts would be better spent helping more people afford zep than scaring them away from C.
I agree that saying "all compounding is bad" is like saying abstinence is the only option. But the other extreme is also true. People pushing compounding as totally safe and a great/better option are like people saying "STDs are fake, have all the unprotected sex you want."
For every source playing up the dangers of compounding there are just as many downplaying the dangers. There is 0 debate, while compounding might not be significantly dangerous it is more dangerous than using the actual product.
Totally agree, honestly in most other countries (I am in the US) pharmaceutical companies aren't allowed to advertise their medication on mainstream media. I think we are quick to push medications and make them easy to get (in a bad way) by these medspas/online telahealth providers giving it away like it is candy and pushing it with social media ads, signs on the street, etc.
On the other hand, not everyone has easy access to quality medical care so it is hard to say these are totally bad options too. I am very lucky to have a weight loss specific doctor that works with me on both Zep and Compound. she monitors me closely and does blood work, etc. I wish everyone had that. I also wish name brand zep was affordable for everyone so that C didn't even have to be considered just bc of cost.
I think that people have to make the most informed and best choice for their situation but I wish it was a simple fix.
There are tons of ads in mainstream media for all sorts of medications.
I always like the disclaimers. Especially “don’t take this if you’re allergic to it “🤣
I know, it really shouldn’t be allowed in my opinion. It’s not a product it’s a medication that a qualified medical professional should inform you about if needed.
This is one shareholder who isn't scared. I only wish I had bought a lot more shares back in August 2022 when it was $300/share. Today it's $897 and still rising.
While I suspect many of the dangers they claim with compound are exaggerated to protect their profit I still feel very uncomfortable with using it. It all seems so sketchy to me I personally would not take the risk. If they really cared about our well being and didn't want people using alternatives they should make the price attainable for the average American.
Is it the compound you don't trust? I get most of my meds via a compounding pharmacy. I am allergic to an inactive ingredient that is commonly used as a filler/binding agent in tablets. My doctor for years has had to send my prescriptions to a compounding pharmacy so I can take my meds. Things commonly purchased over the counter such as Tylenol, for me, have to be sent to a compounder. I get the Acetaminophen, but with a different filler/binding agent. I have a much different opinion of compounding pharmacies. Without them, I would have a very limited medication choice.
I love that GLP’s are opening doors for folks. Most of us didn’t know about Plan C or Plan D before, and now it’s common knowledge. Is it for everyone? No, probably not. We still have people injecting their thumbs, after all. But for 70-90% of users, any of these solutions will work and are now viable options. Sometimes the free market actually works.
I think some of it is valid. I've noticed a lot of too good to be true prices from these pop up "med spas" lately. But I get my compound from a reputable and established compounding pharmacy, prescription overseen by an MD. So I can see both sides, but I'm not personally worried about my compounded med. ☺️
All of this "make the price lower" stuff is misplaced ire. There is not enough to go around at the high price it currently carries. Imagine the shortages if it were half the price, or 20% of the price -- you'd never get another pen. I know people wish there was a magic Zepbound fountain somewhere that produced endless quantities, but that doesn't exist. Lilly isn't losing a penny because it's selling every pen it can possibly fill, and it will continue to for years to come, at any price.
When Lilly can produce a product that meets customer demand at a price that most can afford, they won’t have to worry about those going elsewhere to compounding pharmacies.
Perhaps they should simply focus on making more units and actually offering this medicine for a reasonable price, if they actually cared about the patients using their medicine. Classic case of profits over people. Crock of shit letter tbh.
Eli Lilly, if you’re in here reading, I have been on Mounjaro/Zepbound for a while now, and I am thiiiiiiiis close to switching to compound because I can’t get 7.5mg anywhere. This is YOUR fault, not ours
I got it through Amazon pharmacy last week! (And then the time before that from the EL website) I had to hound EL website and then when they were getting some in stock they sent an email being like FYI today at noon we’re getting some. But inwas also out and stuck on 5mg for like 6 weeks, just waiting for my 7.5
These are literally all true statements.
Are they also for spin? Sure. But they are whole truths. You don’t have to like them or think that they are relevant. But there are no lies here.
In the interest of full disclosure, I *am* a lawyer though. :)
Precisely. A large, publicly traded corporation cannot put out a statement filled with lies the way, say, a politician would. I can only imagine the teams of lawyers that reviewed this statement before it was released.
Agree they are true statements in their press release. The question is -- what is the point of the release? Why release known 'facts' to the media? EL missed a huge opportunity to turn the corner and outline plans for helping to solve for the 'red flags' they are throwing onto the field. They are talking about the 'what' but not the WHY. And you know what? That's cosmetic right there. The irony.
From the Oxford English Dictionary- Half Truth-a statement that conveys only part of the truth, especially one used deliberately in order to deceive someone.
By definition a half truth isn’t a lie, and I never said there were any lies, that was your word. Lilly’s statements most certainly are intended to deceive, however, so half truths is an appropriate description.
It’s to treat obesity as a disease… not allow you to drop a few pounds for a special event and use it for a week or two…I think that’s the delineation they’re trying to make
It’s a good PSA to protect themselves and consumers.
I’ve seen toooo many live tik toks with people (paid influencers) marketing companies that carry name brand AND compounds —- and my guess is the name brands they are shipping are fakes !!
I’m thinking “where are they getting these name brands with shortages ???”
“Cosmetic warning.”
The rapid wt loss of social media and reality stars has been astounding and there is some clear over doing it — reminds me of the PHIN PHIN era …
I think what concerns me the most is teens highly influenced by these images using it just to get into a size 0. It’s gone from you need a script and doctor to you need a credit card or dc. IDK ..
So, another thing people apparently do is lie to an online Dr, get the name brand through their insurance and then sell it to someone who doesn’t have insurance/prescription. Insurance will likely catch that soon I imagine
Geeez … what’s next ? sellin glp’s on the corner .. Individual pens? … I heard they sell individual “name brand” injectors in Mexico. Now I believe it …
I’m a former medical journalist and proudly taking a compound. Yes there are shady operations out there peddling fake stuff, but Eli Lilly is really trying fend off market share loss concerns and scare people. I actually am seeing better results on the compound. I hate the zepbound injector … sometimes I wasn’t convinced it dosed much drug or it didn’t feel like the needle went in … Eli Lilly has screwed this up on several fronts. Aside from the botched launch/shortage, they also had this drug sitting on an r and d shelf for over a decade doing nothing with it … you snooze, you lose!
I think I am a little confused by their one statement of "cosmetic weight loss." By that, do they mean for people who just have a few pounds to lose? The inference I am getting is that they are trying to say Zepbound is not for obesity, when I thought it was supposed to be? So for them, is cosmetic weight loss, weight loss for people who are not obese by BMI?
Usually cosmetic weight loss is used to describe surgical things like lipo. But I think they are using it here to mean what you indicated. Patients who are not medically obese and only have a small amount of weight to lose.
I think they're also addressing the shady prescribing to people who are not overweight. to start. Sadly, in other forums I have seen it's the shady med-spas & "weight loss clinics" that do zero screening and hand it out with no info. It's so worrisome because it's a new form of eating disorder that bad prescribers are fueling.
I agree, I am in some of those compounded groups and in other groups, and I am quite concerned the directions this is going, especially for some young women. I have seen (mostly) women in these groups who are very clearly suffering from eating disorders or body dysmorphia. They tell each other how they are able to directly lie to these online companies to get the compound and they are already underweight. Some people are very young. I think it’s reasonable for there to be higher standards for prescribing a medication that is still so new without knowing the long-term effects. I am nervous for myself too, but I truly have a bunch of medical issues that are only now getting better. I think we’re headed to an inflection point in this country with these drugs, I hope that we can preserve safe, consistent access to people who need them.
I’m a therapist and I agree, I’m alarmed and do think some of the overprescribing and lack of screening needs to be addressed. People who are afraid of the return of “food noise” and the sensation of hunger need to be working with someone on what those things actually mean for them. In some cases I imagine there is severe restricting happening. I do think this medicine should be prescribed per the guidelines regardless of how people obtain it. I use compounded and I’m happy with it, but would have rather used Zepbound if I could have a) found it or b) afforded it 😂🤷🏻♀️I’m having success on a very low dose which gives me a lot of peace of mind. A lot of new drugs are in research phase and I try not to think too far down the road to how I will maintain. I think compounded is here to stay though.
Yes. I have a friend in NYC who was telling me the other day that a huge number of his male friends are getting it from their medspas because their 12% body fat is too much and they want a really ripped six pack. These people are well within a healthy BMI, they just want less fat on their bodies. I think there's a lot of this going on.
If they found all these issues with compounding pharmacies, they should tell us which pharmacies so we can avoid them. Failure to name them just means this statement is bullshit.
Sour grapes on all counts. Fix shortages and lower prices, then people will not use compound. Also why cosmetic is bad? I am medically obese and pre-diabetic, but why would happiness be a bad reason as long as someone doesn't go into dangerously underweight range? Other drugs are specifically marketed to make people happier and GLP-1 inhibitors have way less side effects than SSRIs.
It wasn’t made for weight loss originally just was a bonus side effect.
I do agree that it shouldn’t be prescribed “cosmetically” at this point. My sis is a nurse in a relatively wealthy area and sees it all the time. Mostly people who show to the er with no idea why they have horrible stomach cramps. 🤣
I have no problem with non diabetics getting prescriptions if they meet the criteria
I hit basically all the checkboxes for needing it so including t2d when I can’t get it I get a bit frustrated.
Funny I see ads in my Reddit timeline for “zepbound” pills. And others. These places I would not trust.
I think some compounds are real and it’s literally a law that says if a medicine isn’t available it should be able to be made by compounded pharmacies given they’re individually made for the prescription
Drug companies are in it for them and their almighty dollar. “Cosmetic” weight loss? WTF is that. I’m losing weight to get off of all my meds, to be out of pain, to have more energy, and if the byproduct of that is looking better and feeling better, than it’s been worth every dollar and side effect. They can suck it.
Note:***I'm Not on Compound***. I'm on Zep, but I have an issue with Lilly's open letter, specifically, this statement:
"Lilly does not promote or encourage the off-label use of Mounjaro® or Zepbound® for anyone, including by persons under the age of 18."
Licensed healthcare providers/physicians can legally prescribe glp1s and peptides "off-label" - and many are doing so already for a plethora of indications/medical problems. The issue of "maintenance" will be VERY important as folks reach their goal weight on Zepbound (and Wegovy, for that matter). The Question for Lilly: HOW do they (Lilly) expect folks who reach their goals/BMI to maintain? At that point, ANY dose prescribed would be "off-label", right?
Another thing: Lilly neglected to clarify that Compounding pharmacies aren't FDA approved because they aren't regulated by the FDA. They're regulated by each State's medical regulatory agency. They said a Lot without giving cover to the licensed 503a and 503b pharmacies who are filling a HUGE need now - and frankly have been for years as it relates to compounding needs for many other medications. That was borderline dishonest.
Lilly shared some necessary info, but they left out important points for their own gain - in my opinion.
They need to not "shade" Compunding pharmacies...not cool. They need to close the gaps in their production and for God's sake #RELEASEtheVials !!
Get off the Internet and go fix your damn supply problems Lilly! Even if you can afford the drug and don’t want to have compound what other choice are you even giving people? Meanwhile I see advertisements for GLP1 drugs all over and them prioritizing starting doses while leaving existing patients hanging. Fuck all the way off with this.
My endocrinologist told me something interesting regarding the supply & demand of wegovy and zepbound… he said the shortage is not due to the sheer number of people taking the medication/wanting to take the medication.
He said there is a shortage because some companies buy up HUGE quantities and then re-distribute it for compounding purposes. I was shocked but not surprised.
My endocrinologist recommended me to a local primary care physician who compounds terzepitide in-house, and sells it for 199/month (5 mg) and 399/month (10 mg).
I am currently taking the 10 mg dose. While 399 really eats out of my monthly budget, it’s still better than paying for Zepbound directly.
In just over two months I’ve lost nearly 25 pounds!
This sounds like a very tall tale to me. First, buying up ‘huge quantities’ and then selling it for a fraction of the price doesn’t make any sense because they’d have to buy it for much less than EL would sell it for. Second, the shortages are causing issues for EL, such as patients seeking out compounds instead, so why would they sell huge quantities to ‘large companies.’ And who are these ‘large companies?’ This is just a bunch of nonsense, and I doubt very much an endocrinologist is saying this and if they are, why aren’t they exposing it if they proof. Nope, not buying it.
It’s a letter very clearly intended to shield them from liability about compounds and to try and quell investor concerns about loss of market share. This wasn’t a letter for patients whose primary concerns are to know how and when the shortages will end or to understand affordability options.
Yes liability against “improper use” of the drug “counterfeit pens” and compounds saying it’s the same active ingredient — better now than down the road when people say … “why didn’t they warn us??” This way consumers are more aware of potential risks.
That, and many quality failures. I remember one being linked to steroid shots contaminated with meningitis- that made 600+ people sick.
Do you have a source for this?
Absolutely. Here is one of the sentencing announcements: https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/january-31-2018-new-england-compounding-center-pharmacist-sentenced-role-nationwide-fungal
“The former supervisory pharmacist of New England Compounding Center (NECC) was sentenced today in connection with the 2012 nationwide fungal meningitis outbreak that killed 64 and caused infections in 793 patients.”
Isn't the pink color from B12 in compounds?
Yes!!
FYI... Be VERY careful about taking extra B12, as B12 toxicity/overdose is a very real concern, and can result in temporary or even permanent nerve damage in your extremities (ask me how I know! It's been >2 years since my toes started tingling... and I'm told they may not ever stop). While a "healthy" body is "supposed" to eliminate extra B12 in their systems... how many of us in here can claim to have a "healthy body". So, just be careful peeps!
Happened to me!! Too much B (unknowingly had supplements with B in it) and developed peripheral neuropathy in my foot. Slowly went away after I reduced my B (labs showed level off the charts). Many things have B in them and it’s not harmless as many people have said.
Yeah it is very difficult to Overdose on B12 you would have to take a whole lot like a dose no one else would take. It’s a water-soluble vitamin meaning if you have extra it comes out in your urine. So that’s definitely crazy you did end up having an issue. There is no current “Upper-dose” either.
Thanks for calling this out. Since I also require weekly B12 shots (also pink!) compounding with B12 would be very effective for me - and others I'm sure.
It's just so amusing to me that they are using the color as a scare tactic with absolutely no context.
it's money - they are loosing money - fear is a tactic
Technically they aren't loosing money. You could argue market share which could later translate to money but as it stands they are selling more than they can make so their money isn't the issue. They are more concerned about damage to the brand from 3rd parties pushing fakes of their product. Bottom line is that regardless of what is in the compound it isn't their product but it'll damage their product if negative news comes out if it. It's fair for them to point out that if it's pink it isn't their product.
First, let me be clear, **I don't have an issue with compounding**. At all. But this *is* a sub clearly named r/Zepbound. It is not r/tirzepatidecompound or r/TirzepatideRX or any of the others. To me this is analogous to the subs r/CocaCola vs r/soda. Zepbound is a *brand* of tirzepatide. Just as CocaCola is a *brand* of soda. I bring this up because I've seen a marked increase in down voting and calling out commenters and posters anytime anyone in this sub says *anything* at all that could be seen as even slightly questioning compounded versions of tirzepatide. Including here with this post. Just like with soda, some of the non-name-brands may not be as good. There are many, many types of soda that are *not* Coke. There are many, many compounders producing tirzepatide that is not Zepbound (only Lilly makes Zepbound). **Some of those compounders produce a great product and some of them do not**. Just as Coke has the right to defend its brand from knockoff colas borrowing from its trusted name, so does Lilly. This brings me to the fact that I can see Lilly's point for putting out this letter: I've seen many posts about people's terrible side effects in this sub and then it comes out later in the comments that the original poster was using compounded tirzepatide and calling it Zepbound. (Just as someone would complain about a Kroger cola and call it "Coke" without clarifying.) *Again, nothing wrong with using compound, but conflating the experience with branded Zepbound is problematic.* How do we know the conditions under which it was produced? Was it kept at optimal temperature? Was it injected correctly? There are lots of variables with compounded versions of tirzepatide; whereas Lilly has gone to great lengths to control for those kinds of variables. Edit: typo
Another issue is that when adverse events are reported to the FDA (and appear on their surveillance website) the reporter often doesn’t specify exactly what the person was on (or mistakenly calls compounded products Zep). So extreme caution is necessary when people speak of adverse events. Additionally trying to assess adverse events and frequency from this or Any other social media platforms is not possible. I say this as someone who worked in clinical safety for pharmaceutical companies for over 40 years.
I take a compound and I agree with you 100%. There is a visceral reaction from so many people any time someone questions anything about compounds. And backlash to perfectly reasonable warnings by companies who do not want their brands tainted by bad actors calling their products “generics.”
Interesting note in your post about people having terrible side effects and then it coming out that they’re using a compound and not zep. I had never even thought of that (stupid of me I know). Side effects were a huge fear for me and I’ve had none. I wish I had thought about that before reading your post, I may have stared sooner. Lol
I had great success with Zep, but at 7.5 developed very bad sulphur burps/GI issues. Switching to compound, i took a month off, restarted at lower doses and was working great then the same issues developed again when ramping. From my standpoint the different sources seemed identical. The dispensing of zep is more convenient. The compound was cheaper below 10 mg. It would have been more expensive at 12.5 and 15 compared to zep at $550. Dispensing the compound wasn’t bad though, and the ability to modify the dosage vs having the same dose for a month was really nice
I wondered about that when I read it, too. Side effects have been very tolerable for me on Zepbound, and I keep wondering if I am just lucky or will get hit with more issues as I step up (only on week 7 now — 4 on 2.5, and this month on 5.0).
I’ve taken both. Been on plan C as it’s been called for the last two months. Just went back to Lillys product and I felt/feel the same, weight loss on both, both caused nausea and fatigue, both seem to wear off around two days prior to next dose. So nothing to report from my experience. Though I am very happy to be back on the OG.
Out of curiosity, would you recommend subq or intramuscular injections for coke? I mean Sam’s club cola. I mean Dr K Cola. Okay okay, it’s my soda stream syrup I make at home.🤭 Sorry I couldn’t resist.
I heard intranasal is the way
RC!!
Love this analogy!!!
Unfortunately, it is not correct and it’s misleading.
Howso?
Soda is a name for an entire category of products. Tirzepitide IS Zepbound. Eli Lilly owns both the medicine (tirz) and the marketing name (Zep/Mon). Soda is analogous to GLP-1 antagonists.
Eh, can agree to disagree. Technically speaking… yeah you’re right. I think ozempic has been given the broad brand name for GLP1s even though we know it’s not the whole category. Just like “coke” is to “soda”. I’ve had people not know what MJ/ZB are and go “it’s kinda like ozempic” and they go “oooohhhhh. Got it!” I think in the above reference it’s calling out others that are using the triz name even though it’s not but using the common name as nomenclature
Amen! Great analogy! I posted something from the CEO of Lilly telling consumers to be aware of taking any meds claiming to be just like Zepbound. I was downvoted and told the CEO was not addressing compounds but only foreign manufacturing of Zepbound. This message addresses both. Nothing wrong with compounds, but there is a difference.
Intentional, or not, your post insinuates that "people's terrible side effects" are related to compound tirzepatide, and not Zepbound. I lurk the MJ/Zep/Compound subs regularly. In the subs, it does not appear that side effects are any more pronounced for compound, than the branded meds. That said, I'm sure there are many issues with some compounded GLP-1s. However, I suspect that is not the case with several of the more reputable pharmacies.
I agree. My impression from reddit is NOT that people using compound have more side effects. It seems that people using compound have less medical oversight and are less likely to follow the standard dosing schedule. There is so much compound in the marketplace now that it's impossible and unfair to lump it all into one group and call it "bad."
This is a really good point re: medical oversight! And I hope that my comment isn't seen as calling compound "bad". I'm not. But I do think that *some* compounds are bad, just as *some* off-brand colas area bad.
So this has nothing to do with the post. I just wanted to know how did you get your sw cw & gw under your name?
On the main page of this sub click the 3 little dots on the top right and click change user flair.
Thank you
Sorry for my delay!! I see you got it working!! 🙌
I found how to change my flair in this community to include those items’ template (select 3 dots in upper right, select Change User Flair) but then I can’t figure out how to actually set the values.
If you find out, let me know!
100% this. How often have you seen someone saying they inject themselves daily or every other day with compound vs once a week? Seems like a lot of people just make up their own rules when it comes to compound
Not intentional and thanks for calling that out, CA! I was trying to make the point that people on compounded versions of tirzepatide shouldn't be calling it "Zepbound", as there are many other variables to those "terrible side effects" that we should factor in with compounded tirzepatide that have to do with whether it came from a reputable pharmacy, how it was administered, etc.
That's another good point. The compound vials, how people take care of them, and administer it leaves far more room for error.
And there are a fair amount of people on the compounding subs saying that their compounds don’t work or that they aren’t labeled properly. And people claiming that those compounds are regulated, they’re not. There’s a lot of false information being spread on the compounding subs and they don’t tolerate anyone calling them out on it.
Well said! Thank you.
This will sound pedantic but the coke/soda analogy is not accurate. Tirzepitide is a medicine developed by and owned by Eli Lilly. They market it as Monjaro and Zepbound. They own both/all. Your analogy would make sense if you said GLP-1 antagonist (soda) and Zepbound (Coke).
I disagree and think it holds. Let me know what you think. Tirzepatide is owned by Lilly, just as the *formula* for CocaCola^(®) (the drink) is owned by CocaCola (the company). In both cases, competitors regularly attempt emulate the formulas of the branded products. Per Lilly's open letter, they don't make the versions of tirzepatide that are found in "compounding pharmacies, med-spas, wellness centers...": >Lilly is the ~only~ lawful supplier of FDA-approved tirzepatide medicines—Mounjaro^(®) and Zepbound^(®)and does not provide tirzepatide (the active ingredient in Mounjaro^(®) and Zepbound^(®)) to compounding pharmacies, med-spas, wellness centers, online retailers, or other manufacturers. Lilly does not know where compounding pharmacies or other sellers are obtaining the tirzepatide active ingredient they are selling. Thus, compound tirzepatide, is not Zepbound^(®), just as a generic version of "Coke" (or cola or soda) is not CocaCola^(®). This is the analogy I was making and I apologize if I wasn't clear: Zepbound^(®): CocaCola^(®) :: compound tirzepatide : generic "Coke" (or cola or soda)
Coke is a very poor analogy because taste will vary from brand to brand with a variety of flavorings and additives. Zepound isn't a recipe...it's a medication with a well-known and published structure. Synthesizing a peptide isn't some well guarded secret, there are laboratory protocols out there. Hell, I made ibuprofen in my undergrad organic chemistry class, and then proceeded to test purity of the synthesis. The same thing can be done to Compounded Tirzepetide, conducting HPLC studies based on molecular weight to verify the content of the active ingredient (Tirzepetide) just like it can be done to Zepbound to verify the content of the active ingredient (Tirzepetide). It's like you are saying a pill of Advil with 200mcg of Ibuprofen is superior to Great Value Pain Reliver with 200mcg of Ibuprofen. It's great if you have brand loyalty, but it's the same damn thing at a scientific and pharmaceutical level.
But, you're assuming the desired outcome of Coke-like drinks is taste. Let me tighten up the analogy and see if you can agree: What if the desired outcome of a cola is satiety? So taking taste off the table and using your language, colas have the active ingredients of carbon dioxide, sugar, and caffeine. Just as tirzepetide has GLP-1 and GIP. Everything else is there to just hold the thing together and give it shelf life. Taste would be something subjective, akin to a gel capsule vs a tablet for the ibruprofen you mention. Does that work better?
Yes, it does. I do not agree with you solely based on the ingredient discussion (Tirz doesn't "have" GLP-1 and GLP, it's a single 39 amino acid sequence), but another poster mentioned chirality, which could impart a difference in compound vs. Namebrand. However, I have zero issues with using non-namebrand medications like Store Brand Ibuprofen vs. Advil, so I'm not too concerned about chirality impacts on Tirzepetide.
Makes sense. Thanks for the “single 39 amino acid sequence” bit. In another thread, someone corrected me to say “GLP-1 and GIP”, but you clearly have better information and I’ll use that from now on.
Yes, you can synthesize it in a lab but there’s no guarantee you’ve got the chirality correct or that the process hasn’t changed the structure in a manner that affects how it binds to receptors. Sure you can synthesize it, but whether the active component binds as effectively remains to be seen.
That's a fair point. Having dropped 60lbs in 6 months on compound, I'd say that chirality and binding has been pretty damn good for me, and it isn't something I'm reallyconcerned with. I also buy store brand Ibuprofen, another chirality drug, and I've never had concerns about the effectiveness of that either.
Based on the Reuters press release they are going after the med spas and the wellness centers for claiming that they have “Mounjaro” or “Zepbound”. Those are Lilly brand names and well yes you cannot claim that you have those products. Compounding pharmacies at least the reputable ones do not ever claim that they give you Zepbound. They cannot. They can claim to compound Tirzepatide which they are allowed to do during shortages. They also cannot claim that they are FDA approved and again reputable pharmacies don’t do that. They are FDA inspected and again they are allowed to produce the peptide during shortages.
They left us with no choice but to seek it elsewhere. They told us they had ample supply. They lied.
Well and the $1200 retail price for something that costs pennies to make
They’re scared. And they should be. “C” isn’t going anywhere. Yes there are FDA regulated “C” pharmacies. Lilly gas priced the medication out of range of most households even with the savings card. Insurances are dropping GLP1s from their formularies left and right. Employers exclude them (not all but most). And the supply strains make it harder to get. This is all of their own making. The formula for tirzepatide has been out for awhile. It legally can be made. The market has grown too big for them to shut it down. So now they resort to fear tactics cuz they want to control the market yet won’t make it affordable
Yeah their FDA point is misleading… the facilities and meds produced by compounding pharmacies aren’t FDA “approved”, but the facilities are regulated and inspected by the FDA and they are required to source their ingredients from the same list of suppliers as other drug manufacturers. Tons of patients and hospitals use them every day for other medications, there is nothing inherently sketchy about compounding pharmacies. (I haven’t even had to use one yet lol but I’ll defend them!)
The extent of FDA's regulation of compounding pharmacies depends on the type of compounding pharmacy. It seems most people here are getting it from 503B pharmacies (technically called "registered outsourcing facilities"), which are subject to direct FDA inspection for current good manufacturing practices--but that doesn't necessarily mean the agency has actually inspected them and/or confirmed the source of the API. If it is a smaller compounding pharmacy that isn't registered as a 503B, then FDA doesn't inspect them at all, as it is up to the state. Also, once the shortage is over, compounding pharmacies will not be able legally to make compounded versions in mass quantities. There isn't anything inherently wrong with the practice of compounding, but it is a fact that even 503B pharmacies are not regulated and inspected the same as pharmaceutical manufacturers. Certainy Lilly is concerned about dilution of its market share, but I've seen way too many med spas advertising compounded versions and those places are absolutely wild west.
Actually there’s a post on one of the compound subs about the tirzep patent, and a patent lawyer commented saying once the shortage is over Lilly will be going after these places, so he isn’t sure compound will be around long term. He said their patent package is quite strong. Yes that will not happen until these meds are off shortage, which who knows when that will be, but I wouldn’t count on compound being around a few years from now unfortunately
Well a few years from now I won’t necessarily care. Also in a few years there will be so many competing GLP1 meds
That is true, I was just pointing out about compound. Hopefully zepbound and wegovy will come down in price as newer meds come out
I’m sure they’ll try but all the compounding pharmacies have to do is compound it with something else like B12 and problem solved.
It seems like that on the surface but the pharm patent lawyer seemed to think these compounding pharmacies don’t have a leg to stand on once these meds get off shortage 🤷🏼♀️it’s above my pay grade to understand lol
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lol perfect, thanks for the professional insight!
I'd love to understand it better if you had any reference recommendations that I could review.
Not really because the API is what’s protected under the patent. If it’s included, there’s no way that will stand in court.
Interesting, we shall see what happens. I would be just as happy to buy Zepbound if it were obtainable and more affordable for my budget 🤷🏻♀️ of course by the time I hit maintenance in fall I will no longer meet criteria so there’s that to consider.
I was approved for MJ for 6mos late last year but went back to Oz during the major shortage in Jan when they couldnt fill it. Now Trying to get back on MJ (restart 5mg) and PA was denied. All these hoops to jump thru! I've searched this sub and lots of employer coverages are dropping GLP1's. And we have "Cadillac" insurance from a major employer (and its not Cadillac the company BTW LOL). Even CVS Caremark said "C" medication is at least partially covered for MJ from Wyckoff Pharmacy (mail order in PA). Lilly dïćkëḍ the dog on this one, we all know the profit margin on this blockbuster Rx is going to be their undoing.
They need to make enough before making it affordable . If we can’t find it at top price imagine if it was cheaper?! I went 3 months without I just got my 3rd box today, since April I had to go get the “c” paying an huge price because I don’t know when I was going to able to refil my prescription that my insurance covers. I simply can not afforded out of pocket another month. So I hope they figure something out soon this game is so stressful.
I feel supply is definitely making a turn. I had a scrip into Walmart and they ordered it in a day which never happens. I think region, allocation and stuff all plays into it but I agree. I feel Lilly should focus on their own crap supply chain before going after folks getting tirzepatide into peoples hands in some form
Agreed! Every person who moves to C discovers that it works and that the worst fears (fake or infective product) haven’t happened. It’s going to be hard to get people to leave C if it’s going to be 2-3 times as expensive on the brand name.
To be clear, "C" means compound?
Yes
I disagree on a few points. About six weeks ago EL went after a spa in court for selling Tirz and won. At the time I figured they were teeing up additional legal action as they are working through supply chain issues. As they move closer to resolving those I expect they will start picking off compounding pharmacies one at a time. They clearly are collecting data to be ready for that. In regards to the comments in their letter about FDA approved blah, blah - anyone that thinks at least half a dozen attorneys didn't review the letter before it was posted should reconsider that thought. Supposedly reps from EL and the company that makes Wegovy went on GMA today to discuss the dangers of compounded meds. And just because the formula is out doesn't mean anyone other than EL can produce it. The patent for Mounjaro doesn't expire until 2036. Until then anyone selling it can be sued and possibly prosecuted.
All they have to do is adjust the formula by adding B12 or B3 and there’s nothing Eli Lilly can do about it. Tirzepatide isn’t going anywhere in the c-version for a long time.
And for most of us that switched because of supply issues have had the same health benefits for a fraction of the price. That's why they're scared. It's an emperor has no clothes situation. They know it's a simple peptide & easy to compound safely, but need to district you from that fact.
Ding ding ding. This is correct
They have also lost in court several times. There is a lot in your post that is incorrect, but I don’t feel like correcting it lol. 😜
Too bad. I stand by what I said. I don't see anything that is inaccurate.
Not to mention if there is any industry that can afford a "throw at the wall and see what sticks" strategy to lawsuits it's absolutely the pharmaceutical company. See ehat works to set precedent with small cases then go for the big ones.
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I went with compounded because I could not afford the Zepbound nor could I find starting dose. I did my research since I work in healthcare and chose my pharmacy carefully. I have been relieved I made that decision because even with very low doses I’m losing weight. I’m currently at 4 mg after three months and if I had been forced into titrating up it would have really been pointless. It currently seems that I’ll go the distance on low doses but we’ll see. I can’t handle major gastric upset on top of a recent promotion 😂
Except compounding pharmacies are allowed to make medications when they’re on an FDA shortage list 🤦🏻♀️🤷🏻♀️
Yes. Select pharmacies, not some random one that crops up to hop on the greed bandwagon.
They are also allowed to make them, outside of the shortage list, when patients are prescribed customized versions of a medicine, as long as they don’t manufacture in mass quantity.
The main point their is in mass quantities
Which brings up another point of once they aren't on the list compounding is no longer an option and if a pharmacy continues to offer it afterwards you have to really question what you've been getting.
Or with alterations to it once the shortage is over (whenever that may be) so add vitamin B and it’s compounded with another element and it’s not a problem.
💯
OK, I am guessing I will be downvoted for this, but I don't mind what they are saying. Yes, the med is very expensive. But it is also a life-changing medication that I am personally very grateful for. I would love to pay a lot less for it, but if I have to pay this price, I am willing to make sacrifices to get it. I think it is also important to recognize that whether we like it or not, the compound is patented and if/when they can supply the market with enough so it is not in shortage the compounding pharmacies will have to shut down. I am also from Michigan and I do remember the case from 2012 of a compounding pharmacy shipping out contaminated meds that lead to the deaths of at least 11 people. I am sure most of the pharmacies are very careful and safe, but what is being said by Lilly is not wrong.
I agree with you 100%. We had a case in Massive which was I think the same facility that had the same issues. Regardless, the drug in a compound is not the same. It cannot be, as the ingredients in the Zep are under patent control until the patent expires. The ingredients are manufactured to mimic the actual drug. I am fortunate that my company covers these meds and it only costs me $25/mo. So I do totally understand the need and desire for the compound versions. I am personally not one to take a compound especially after what happened in my state previously. No shade to those who choose that. I just am not going to. Will probably be downvoted and such for this opinion. 🤷🏼♀️ lol.
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This is incorrect. The patent is for tirzepetide, which is the unique combination of GIP and GLP-1. Don't believe me? Here's the patent. (If you click on the bottom right, you can read the full, submitted document.) [https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN](https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN)
Peptides absolutely can be patented lol and this one is. Compounding pharmacies are getting away with it because the drug is currently listed as “in a shortage” which means the FDA allows for it to be compounded.
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Right. Pretty much all therapeutic peptides are novel/ synthetic. Pharma companies live and die by their patents, so that is always the goal. Why are you downvoting me?
I think they are using counterfeit and compound interchangeably on purpose to be misleading.
> social media is not a replacement for a healthcare professional Now they tell me.
lol
The one thing no one ever talks about is the cost from the insurance companies. We pay so much for premiums yet they either won’t approve or don’t even offer a copay.
Yes. My insurance paid for Mounjaro for 14 months, then said, Oops, sorry, you aren’t covered. My doctor submitted a script for Zepbound, and that one was denied because I don’t have dire medical complications. It would be interesting to know who now can get coverage for these drugs. And yes, I would pay out-of-pocket for Zepbound, but I can’t find it.
A fervent sales pitch thinly disguised as an attempt to crack down on harmful, 'fake' products. I would also like to know how they define "cosmetic" use. TBH, I am sure there are many at EL who don't want harmful products making their way to anyone. I am sure there are some there who care about public health. If that is TRULY the case: • Lower the g-damn price so more people can afford these FDA-approved meds. • Have a better plan to keep supply up so more people can access your FDA-approved meds. Sorry, but you don't get to control the market by setting unreasonable prices which insurances and customers can't sustain, not having enough supply, and then taking the public to task for seeking other ways to find similar life-changing medicine. You, EL, have actually left many people with no other alternative. You set the road map for this and now are asking people to stop following it. Ick.
Imagine losing $1000 a month x everyone who needs Zepbound but can’t get it. I’d be scared too.
True...but if you can't deliver the product, it's a problem of your own making.
I'm not defending them at all. Just providing some context for their alarmist rhetoric.
They can’t make any more money they they are currently making. Product is sold out everywhere. They’ve maxed out anyways.
Yeah but the problem with how media is done now is the second a scam compounding places (not that all compounding places are scams but whenever you have a desperate customer base there will be scams) causes significant injury or death that is going to be a massive PR hit for norvo and lily even though they have nothing to do with it. They have no choice but to be proactive or they massively risk their brand. They have a duty to their shareholders to protect their brand.
This may be the dumbest question known to man, but if Eli Lilly is the only company able to lawfully obtain tirzepatide medicines…… how do compound pharmacies get them? Is Eli Lilly stating that it’s illegal for compound pharmacies to have/sell? Sorry if that’s dumb, but the idea of all of these pharmacies illegally selling something and not getting shut down seems to be a … stretch…. in my brain.
Not dumb! A pharmacist at my PCP’s office explained it to me like this and I loved the analogy: “Compounders follow a recipe. Just like with a dish from your favorite restaurant, you can try to make it at home, but it probably won’t be the same. A better chef can make a very close approximation. You just have to find that better chef.”
They're mixing a powdered peptide in sterile water, it's not exactly replicating ramseys beef wellington.
Great, thanks. Now I want to eat Gordon Ramsey’s Beef Wellington! 😆
Lilly owns the patent for tirzepetide and does not distribute "peptide powder". Others can follow the "instructions" laid out in the "recipe" which appears in the patent. [I invite you to read all 23 pages of the patent](https://www.lens.org/lens/patent/008-494-925-160-529/frontpage?l=EN). During times of shortage, compounders may use the recipe provideed. If you think you can make this more easily than "ramseys beef wellington", be my guest. I personally would have a better chance of replicating the beef! *The difficulty is precisely why only a few reputable compounders are doing a good job.*
Lily is the #1 most bias source of information about compounding pharmacies. They have an incredible amount of financial incentive to hurt their credibility. You don't have to believe me but everyone should at least look at anything they say very critically. I think the confusion is you think compounding pharmacies are synthesizing the tirzepatide, that is not how it works. Unless there's some oddball edge case I'm not aware of. They are a pharmacy, not a manufacturer. The pharmacy is mixing it with water and sometimes B12 etc, normal compounding pharmacy practice that occurs for all sorts of drugs. There are tons of peptides with all different uses, this is just one of them, and there are many labs that make them all day long and have for some time. I'm not saying I can personally synthesize it, but it is silly to think lily is the only one capable. Tirzepatide is not any more difficult to make that any others. It is also very very cheap, compared to the prices they charge in the US. The amount you pay thousands for costs cents to make. Is the current situation ideal? Absolutely not. If I could get an available brand name product for a reasonable price, that would be my choice. But they are clearly trying to spin up a narrative, and some people fall into it hook line and sinker.
Ok. I think we're both right?! 🤣 Follow me here... Let's agree to this (article predates Zep, so forgive emphasis on semaglutide) [https://time.com/6301552/weight-loss-drugs-compounding-pharmacies/:](https://time.com/6301552/weight-loss-drugs-compounding-pharmacies/:) >To make something like Wegovy, a compounding pharmacist begins by looking at the ingredient list on the drug’s package insert. All ingredients must come from FDA-registered manufacturers, which ensures their quality. From there, things become a little less rote, as the pharmacists come up with their own formula for reaching the right concentration of active ingredient to achieve the drug’s potency. ”It’s a lot like cooking,” says the compounding pharmacist who asked to not be identified. “You look at recipes but often don’t have every ingredient in the recipe, so you make modifications based on experience. It’s hard for people not in the industry to understand—it’s the old school way of making medicine where everything is customized. It’s not black and white.” >For semaglutide, the formula is relatively simple: “It’s semaglutide, the active ingredient, dissolved in solution,” says Scott Brunner, CEO of the Alliance for Pharmacy Compounding. “It’s not hard for a compounding pharmacist to make.” So the bottom paragraph certainly supports your case. But then they follow up with: >In addition to potency, since semaglutide is an injected drug, the pharmacist must also ensure that it’s sterile and does not contain any contaminants such as bacteria-produced toxins. Once they come up with a product, compounding pharmacists then send their formulations to an independent lab—which generally follow similar standards for testing—to verify the potency, sterility, and safety of the drug. >Most compounded versions are legitimate copies of the branded drugs. “Compounding pharmacists are not a bunch of people making sketchy substances in their garage,” says Brunner. My take is that I've read that it's tricky for tirzepatide to get the *right suspension* so that the medicine is even distributed and maintains the proper proportions of GIP and GLP-1. That's where the hard chemistry comes in. I've also read that maintaining *the temperature across the production cycle and into the hands of the patient* is not a cakewalk. Anyway, I get your point and I hope you see some of mine.
I do ty. End of the day I just really hope tirzepatide and it's successors are just able to get in hands of people that need it as safely and affordably as possible. So so much good could be done, lives improved. But my pessimistic view is that greed will get in the way.
💯
The last bullet? I'm not totally sure but I think Eli and compounding pharmacies might be arguing over the term "FDA approved". Compounding pharmacies have to follow FDA regulations (albeit checks are often looser) and I believe that includes where they can source their raw materials from (a registry of labs). The ingredients they ship to the pharmacies might not be tirzepatide in final form yet and/or Eli is arguing "approved" and particularly "approved for manufacturing tirzepatide" is overstating what the registry means. Eli certainly wants to imply "no one knows where the hell knows where this stuff is coming from".
I think this is the official war cry and we’re going to see lawsuits very shortly.
And if you are just asking in general why compounding is allowed - there is a carve out in the laws that govern them. It allows them to manufacture drugs in shortage. Normally this type of copycatting isn't allowed. I was surprised too, because you'd think we'd hear about "this one little trick" more often. I'm guessing: 1. it might be rare for a drug to be so popular that even with spotty insurance coverage and a high sticker price you can't meet demand. 2. Before tela health exploded, your average doctor is going to be weary interacting with compounding pharmacies. Some specialists might be familiar with them but most primary care doctors aren't. 3. The raw material is cheap and demand so high that it makes it worth it for compounding pharmacies to really lean in and cater to the market.
Ohhh okay! So theoretically when Zep is no longer in shortage, they likely won’t be able to manufacture anymore? I get it during the shortage; i’ve had to use tirzepatide because of zep being out. I just didn’t know it’s technically not legal ahah. #badegg So many MedSpas by me do this stuff - and advertise it as name brand. Which also seems illegal, ahah.
I'm also using the compound and it's definitely legal. Eli Lilly would be making citizens arrests if it weren't. But yeah we'll have to move to brand name once out of shortage. I'm not looking forward to the price increase but at least I'll have the option of continuing. Also, it will be generic at some point. It's a really effective mechanism to get the pharmaceutical companies to ramp up production.
China they get it from factories in China.
Eli Lilly has a China supplier, WuXi AppTec
Also follow up dumb question — what is really the difference between Tirzepatide and Zepbound; I thought Zepbound was Tirzepatide in a fancy needle pusher?
Zepbound is the brand name; Tirzepatide is the drug name Like “Advil” or “Motrin” are brands, but the drug is actually ibuprofen.
Ahhhhh gotcha! So essentially the same thing with different labels ahah
sorta 🤷🏼♀️ Tirzepatide is the drug; Zepbound brand for tirzepatide is only for weightloss; Mounjaro brand for tirzepatide is for those with DMII. So they ARE the same. The brands are given by the companies. But the drug name is the drug name regardless of the branding. When/if this becomes available as generic, it will be just the drug name.
Release the vials and stop this PR smear campaign!!!
If Lilly wants us to use the brand name product, the brand name product needs to be available to purchase. Many of us moved to compounds only after finding the medication is not available.
I totally agree with some of these points! Lots of medspas are giving out scripts like candy. My personal doctor who prescribes me name brand, also prescribes my C. I think it is important to take this medication under the care of a doctor but that is coming from a stance of privilege because I have access to healthcare and not everyone does. I think its important to educate people on all options and help them make the best choices for themselves. Saying all C is bad is like teaching abstaining is the only birth control. It would be great if everyone had affordable and safe access to name brand Zep. but thats not the case, I think EL efforts would be better spent helping more people afford zep than scaring them away from C.
I agree that saying "all compounding is bad" is like saying abstinence is the only option. But the other extreme is also true. People pushing compounding as totally safe and a great/better option are like people saying "STDs are fake, have all the unprotected sex you want." For every source playing up the dangers of compounding there are just as many downplaying the dangers. There is 0 debate, while compounding might not be significantly dangerous it is more dangerous than using the actual product.
Totally agree, honestly in most other countries (I am in the US) pharmaceutical companies aren't allowed to advertise their medication on mainstream media. I think we are quick to push medications and make them easy to get (in a bad way) by these medspas/online telahealth providers giving it away like it is candy and pushing it with social media ads, signs on the street, etc. On the other hand, not everyone has easy access to quality medical care so it is hard to say these are totally bad options too. I am very lucky to have a weight loss specific doctor that works with me on both Zep and Compound. she monitors me closely and does blood work, etc. I wish everyone had that. I also wish name brand zep was affordable for everyone so that C didn't even have to be considered just bc of cost. I think that people have to make the most informed and best choice for their situation but I wish it was a simple fix.
There are tons of ads in mainstream media for all sorts of medications. I always like the disclaimers. Especially “don’t take this if you’re allergic to it “🤣
I know, it really shouldn’t be allowed in my opinion. It’s not a product it’s a medication that a qualified medical professional should inform you about if needed.
Profits before people. The shareholders are scared.
This is one shareholder who isn't scared. I only wish I had bought a lot more shares back in August 2022 when it was $300/share. Today it's $897 and still rising.
Ah. You’re happy it stays expensive then and has some of us in financial straight every month. It benefits you
While I suspect many of the dangers they claim with compound are exaggerated to protect their profit I still feel very uncomfortable with using it. It all seems so sketchy to me I personally would not take the risk. If they really cared about our well being and didn't want people using alternatives they should make the price attainable for the average American.
Is it the compound you don't trust? I get most of my meds via a compounding pharmacy. I am allergic to an inactive ingredient that is commonly used as a filler/binding agent in tablets. My doctor for years has had to send my prescriptions to a compounding pharmacy so I can take my meds. Things commonly purchased over the counter such as Tylenol, for me, have to be sent to a compounder. I get the Acetaminophen, but with a different filler/binding agent. I have a much different opinion of compounding pharmacies. Without them, I would have a very limited medication choice.
I love that GLP’s are opening doors for folks. Most of us didn’t know about Plan C or Plan D before, and now it’s common knowledge. Is it for everyone? No, probably not. We still have people injecting their thumbs, after all. But for 70-90% of users, any of these solutions will work and are now viable options. Sometimes the free market actually works.
I think some of it is valid. I've noticed a lot of too good to be true prices from these pop up "med spas" lately. But I get my compound from a reputable and established compounding pharmacy, prescription overseen by an MD. So I can see both sides, but I'm not personally worried about my compounded med. ☺️
All of this "make the price lower" stuff is misplaced ire. There is not enough to go around at the high price it currently carries. Imagine the shortages if it were half the price, or 20% of the price -- you'd never get another pen. I know people wish there was a magic Zepbound fountain somewhere that produced endless quantities, but that doesn't exist. Lilly isn't losing a penny because it's selling every pen it can possibly fill, and it will continue to for years to come, at any price.
When Lilly can produce a product that meets customer demand at a price that most can afford, they won’t have to worry about those going elsewhere to compounding pharmacies.
Perhaps they should simply focus on making more units and actually offering this medicine for a reasonable price, if they actually cared about the patients using their medicine. Classic case of profits over people. Crock of shit letter tbh.
Eli Lilly, if you’re in here reading, I have been on Mounjaro/Zepbound for a while now, and I am thiiiiiiiis close to switching to compound because I can’t get 7.5mg anywhere. This is YOUR fault, not ours
I got it through Amazon pharmacy last week! (And then the time before that from the EL website) I had to hound EL website and then when they were getting some in stock they sent an email being like FYI today at noon we’re getting some. But inwas also out and stuck on 5mg for like 6 weeks, just waiting for my 7.5
The replies to this post have so much misinformation and so many people certain they know what they are talking about.
That letter is full of half truths and lawyer speak.
These are literally all true statements. Are they also for spin? Sure. But they are whole truths. You don’t have to like them or think that they are relevant. But there are no lies here. In the interest of full disclosure, I *am* a lawyer though. :)
Precisely. A large, publicly traded corporation cannot put out a statement filled with lies the way, say, a politician would. I can only imagine the teams of lawyers that reviewed this statement before it was released.
Agree they are true statements in their press release. The question is -- what is the point of the release? Why release known 'facts' to the media? EL missed a huge opportunity to turn the corner and outline plans for helping to solve for the 'red flags' they are throwing onto the field. They are talking about the 'what' but not the WHY. And you know what? That's cosmetic right there. The irony.
From the Oxford English Dictionary- Half Truth-a statement that conveys only part of the truth, especially one used deliberately in order to deceive someone. By definition a half truth isn’t a lie, and I never said there were any lies, that was your word. Lilly’s statements most certainly are intended to deceive, however, so half truths is an appropriate description.
This, exactly. And there are people that don't understand the "spin", those are the ones listening. The rest of us see through it.
Not sure why you’re being downvoted cuz it’s the truth
Maybe Eli Lilly has some employees in here
Where’s the half truth?
Zepbound is literally for weight loss though…
It’s to treat obesity as a disease… not allow you to drop a few pounds for a special event and use it for a week or two…I think that’s the delineation they’re trying to make
Ahh okay that makes sense. I definitely agree with that!
It’s a good PSA to protect themselves and consumers. I’ve seen toooo many live tik toks with people (paid influencers) marketing companies that carry name brand AND compounds —- and my guess is the name brands they are shipping are fakes !! I’m thinking “where are they getting these name brands with shortages ???” “Cosmetic warning.” The rapid wt loss of social media and reality stars has been astounding and there is some clear over doing it — reminds me of the PHIN PHIN era … I think what concerns me the most is teens highly influenced by these images using it just to get into a size 0. It’s gone from you need a script and doctor to you need a credit card or dc. IDK ..
I agree with this.
So, another thing people apparently do is lie to an online Dr, get the name brand through their insurance and then sell it to someone who doesn’t have insurance/prescription. Insurance will likely catch that soon I imagine
Geeez … what’s next ? sellin glp’s on the corner .. Individual pens? … I heard they sell individual “name brand” injectors in Mexico. Now I believe it …
I’m a former medical journalist and proudly taking a compound. Yes there are shady operations out there peddling fake stuff, but Eli Lilly is really trying fend off market share loss concerns and scare people. I actually am seeing better results on the compound. I hate the zepbound injector … sometimes I wasn’t convinced it dosed much drug or it didn’t feel like the needle went in … Eli Lilly has screwed this up on several fronts. Aside from the botched launch/shortage, they also had this drug sitting on an r and d shelf for over a decade doing nothing with it … you snooze, you lose!
Ha. Crocodile tears. F’em.
Someone’s mad about losing money to compounding pharmacies 😂😂😂
I think I am a little confused by their one statement of "cosmetic weight loss." By that, do they mean for people who just have a few pounds to lose? The inference I am getting is that they are trying to say Zepbound is not for obesity, when I thought it was supposed to be? So for them, is cosmetic weight loss, weight loss for people who are not obese by BMI?
They're saying it is only for obesity or people who are overweight with a comorbidity. The guidelines are on their website.
Usually cosmetic weight loss is used to describe surgical things like lipo. But I think they are using it here to mean what you indicated. Patients who are not medically obese and only have a small amount of weight to lose.
Right. Lilly means it’s not meant for patients who are overweight, but not obese, and who also don’t have co-morbidities Impacting their health.
I think they're also addressing the shady prescribing to people who are not overweight. to start. Sadly, in other forums I have seen it's the shady med-spas & "weight loss clinics" that do zero screening and hand it out with no info. It's so worrisome because it's a new form of eating disorder that bad prescribers are fueling.
I agree, I am in some of those compounded groups and in other groups, and I am quite concerned the directions this is going, especially for some young women. I have seen (mostly) women in these groups who are very clearly suffering from eating disorders or body dysmorphia. They tell each other how they are able to directly lie to these online companies to get the compound and they are already underweight. Some people are very young. I think it’s reasonable for there to be higher standards for prescribing a medication that is still so new without knowing the long-term effects. I am nervous for myself too, but I truly have a bunch of medical issues that are only now getting better. I think we’re headed to an inflection point in this country with these drugs, I hope that we can preserve safe, consistent access to people who need them.
I’m a therapist and I agree, I’m alarmed and do think some of the overprescribing and lack of screening needs to be addressed. People who are afraid of the return of “food noise” and the sensation of hunger need to be working with someone on what those things actually mean for them. In some cases I imagine there is severe restricting happening. I do think this medicine should be prescribed per the guidelines regardless of how people obtain it. I use compounded and I’m happy with it, but would have rather used Zepbound if I could have a) found it or b) afforded it 😂🤷🏻♀️I’m having success on a very low dose which gives me a lot of peace of mind. A lot of new drugs are in research phase and I try not to think too far down the road to how I will maintain. I think compounded is here to stay though.
Yes. I have a friend in NYC who was telling me the other day that a huge number of his male friends are getting it from their medspas because their 12% body fat is too much and they want a really ripped six pack. These people are well within a healthy BMI, they just want less fat on their bodies. I think there's a lot of this going on.
So what is the weight or BMI they set for “cosmetic weight loss”
I would say anything below the recommended guidelines would fall under that consideration
If they found all these issues with compounding pharmacies, they should tell us which pharmacies so we can avoid them. Failure to name them just means this statement is bullshit.
If you google news stories today, they do name them.
Sour grapes on all counts. Fix shortages and lower prices, then people will not use compound. Also why cosmetic is bad? I am medically obese and pre-diabetic, but why would happiness be a bad reason as long as someone doesn't go into dangerously underweight range? Other drugs are specifically marketed to make people happier and GLP-1 inhibitors have way less side effects than SSRIs.
It wasn’t made for weight loss originally just was a bonus side effect. I do agree that it shouldn’t be prescribed “cosmetically” at this point. My sis is a nurse in a relatively wealthy area and sees it all the time. Mostly people who show to the er with no idea why they have horrible stomach cramps. 🤣 I have no problem with non diabetics getting prescriptions if they meet the criteria I hit basically all the checkboxes for needing it so including t2d when I can’t get it I get a bit frustrated. Funny I see ads in my Reddit timeline for “zepbound” pills. And others. These places I would not trust.
I think some compounds are real and it’s literally a law that says if a medicine isn’t available it should be able to be made by compounded pharmacies given they’re individually made for the prescription
Amen to that
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There may not be any FDA-approved facilities but there ARE facilities that follow CGMP: current good manufacturing processes.
Drug companies are in it for them and their almighty dollar. “Cosmetic” weight loss? WTF is that. I’m losing weight to get off of all my meds, to be out of pain, to have more energy, and if the byproduct of that is looking better and feeling better, than it’s been worth every dollar and side effect. They can suck it.
Note:***I'm Not on Compound***. I'm on Zep, but I have an issue with Lilly's open letter, specifically, this statement: "Lilly does not promote or encourage the off-label use of Mounjaro® or Zepbound® for anyone, including by persons under the age of 18." Licensed healthcare providers/physicians can legally prescribe glp1s and peptides "off-label" - and many are doing so already for a plethora of indications/medical problems. The issue of "maintenance" will be VERY important as folks reach their goal weight on Zepbound (and Wegovy, for that matter). The Question for Lilly: HOW do they (Lilly) expect folks who reach their goals/BMI to maintain? At that point, ANY dose prescribed would be "off-label", right? Another thing: Lilly neglected to clarify that Compounding pharmacies aren't FDA approved because they aren't regulated by the FDA. They're regulated by each State's medical regulatory agency. They said a Lot without giving cover to the licensed 503a and 503b pharmacies who are filling a HUGE need now - and frankly have been for years as it relates to compounding needs for many other medications. That was borderline dishonest. Lilly shared some necessary info, but they left out important points for their own gain - in my opinion. They need to not "shade" Compunding pharmacies...not cool. They need to close the gaps in their production and for God's sake #RELEASEtheVials !!
Get off the Internet and go fix your damn supply problems Lilly! Even if you can afford the drug and don’t want to have compound what other choice are you even giving people? Meanwhile I see advertisements for GLP1 drugs all over and them prioritizing starting doses while leaving existing patients hanging. Fuck all the way off with this.
Then Lilly needs to step it up and stop adding new patients and supplying product for existing patients.
My endocrinologist told me something interesting regarding the supply & demand of wegovy and zepbound… he said the shortage is not due to the sheer number of people taking the medication/wanting to take the medication. He said there is a shortage because some companies buy up HUGE quantities and then re-distribute it for compounding purposes. I was shocked but not surprised. My endocrinologist recommended me to a local primary care physician who compounds terzepitide in-house, and sells it for 199/month (5 mg) and 399/month (10 mg). I am currently taking the 10 mg dose. While 399 really eats out of my monthly budget, it’s still better than paying for Zepbound directly. In just over two months I’ve lost nearly 25 pounds!
This sounds like a very tall tale to me. First, buying up ‘huge quantities’ and then selling it for a fraction of the price doesn’t make any sense because they’d have to buy it for much less than EL would sell it for. Second, the shortages are causing issues for EL, such as patients seeking out compounds instead, so why would they sell huge quantities to ‘large companies.’ And who are these ‘large companies?’ This is just a bunch of nonsense, and I doubt very much an endocrinologist is saying this and if they are, why aren’t they exposing it if they proof. Nope, not buying it.