Compounded GLP-1s occupy an awkward regulatory space. They are not FDA-approved finished drug products, the FDA does not review them for safety, effectiveness or quality, and the agency has warned about fraudulent compounded semaglutide and tirzepatide carrying false label information. Eli Lilly has separately warned that it found significant levels of an impurity in certain compounded tirzepatide products containing vitamin B12.
None of that makes every compounded program reckless. Licensed 503A and 503B pharmacies operate under real state and federal oversight, and millions of patients have used compounded GLP-1s without incident. But it does mean the quality of your provider matters far more here than it would for a brand-name prescription, because you are relying on the pharmacy rather than on FDA review.
So this ranking weights disclosure heavily. A provider that names its compounding pharmacy is telling you something you can verify. A provider that publishes its full price ladder is telling you what you will pay at 15 mg, not just at 2.5 mg. A provider that writes down its refund terms — even unfavourable ones, as Coby Health does — is treating you as an adult.
Before you commit, it is worth checking whether FDA-approved medication is now within your budget. NovoCare Pharmacy sells Wegovy and Ozempic from $149/mo and LillyDirect sells Zepbound from $299/mo, which has closed much of the gap that made compounding compelling in the first place.
How we ranked these
- Whether the company names the 503A or 503B compounding pharmacy that prepares the medication
- Whether pricing is flat across doses, or escalates every time you titrate
- Whether cancellation and refund terms are published in writing
- Total real cost including any membership fee, at a therapeutic dose rather than a starter dose
- Billing interval and auto-escalation defaults
- Depth of clinical oversight — provider access, lab policy and stated eligibility criteria
We do not rank on star ratings for these providers because we do not collect verified patient reviews for them. Rankings reflect published pricing, fee structure, policy transparency and medication type only. See our full methodology and affiliate disclosure.
The ranking
Why it ranks here: Names Hallandale Pharmacy and VialsRx as its 503A partners, charges the same price at every dose, adds no membership fee and includes free next-day air. $135 semaglutide and $199 tirzepatide. The predecessor Piper brand's low Trustpilot score is the one caveat.
- Membership:
- None.
- Insurance:
- No insurance needed; Polly operates on a self-pay basis.
Why it ranks here: The cheapest way to titrate. $99 semaglutide and $149 tirzepatide hold at every dose, with no membership, no auto-rebill and no subscription to cancel — the price locked at checkout is the price at 2.4 mg. Consultation and cold-chain shipping are included, and there is a 100% refund if the provider declines. It ranks below Polly on our first criterion because it does not publish which 503A pharmacy fills the prescription — it names it on request — and payment is taken before clinical review.
- Membership:
- None.
- Insurance:
- Not accepted.
Why it ranks here: Names Olympia Pharmaceuticals and Empower Pharmacy — both large 503B outsourcing facilities — bundles everything into one price with no membership fee, and offers a written refund guarantee. Down to $99/mo on an annual plan.
- Membership:
- None.
- Insurance:
- Not stated.
Why it ranks here: Names Rush Pharmacy as its 503A partner and explicitly states its product is never research-grade. Flat $149.99/mo covering all semaglutide doses, month-to-month with no lock-in and no-penalty cancellation.
- Membership:
- None.
- Insurance:
- Not stated.
Why it ranks here: The most complete published pricing in the category — the entire dose-by-dose ladder for both molecules — plus written cancellation terms, including honestly disclosing the $50 non-refundable clinical fee and the no-refunds-after-shipping rule.
- Membership:
- None.
- Insurance:
- Coby states it is not in network with any insurance company and does not accept insurance as payment.
Why it ranks here: States its compounded medication is made in state board of pharmacy licensed sterile compounding pharmacies that are FDA-inspected 503B facilities — a stronger sourcing claim than most — and charges no extra fee for dose changes.
- Membership:
- $49/mo, covering ongoing care support.
- Insurance:
- Cash-pay only.
Why it ranks here: Publishes explicit BMI eligibility criteria and states plainly that not all patients qualify, which is rare. Unlimited provider consults, 24/7 clinical support, weekly dose adjustments and confirmed HSA/FSA eligibility.
- Membership:
- $74.
- Insurance:
- Not billed directly for compounded medication.
Why it ranks here: The clearest refund window we found: full refund within 5–10 business days if you cancel before the pharmacy fills your order. Oral and injectable formats for both molecules. Does not name its pharmacies, and covers 34 states.
- Membership:
- None stated separately; the monthly program price is the all-in charge.
- Insurance:
- Not stated.
Why it ranks here: All-inclusive dose-level pricing that folds the provider visit into the medication price, with the full ladder published and some levels supplying five weeks rather than four. HSA/FSA cards accepted.
- Membership:
- None.
- Insurance:
- Not stated.
Why it ranks here: No membership fee, shipping included in the price, sublingual as well as injectable formats, and clinicians who specialize in midlife and menopause rather than generalists working from a questionnaire.
- Membership:
- None.
- Insurance:
- Midi is in-network with most PPO plans for visits.
Why it ranks here: Holds your price flat as your dose adjusts and gives you a genuine choice between compounded home delivery and a $60/mo care-only track that lets you fill brand-name medication on your insurance.
- Membership:
- No separate membership for the home-delivery plans.
- Insurance:
- The care-only track is designed so you can use insurance at a local pharmacy for brand-name medication.
Why it ranks here: LegitScript certified — an independent accreditation most competitors here do not hold — with all-inclusive pricing from $99, no membership fee, and a stated cancel-any-time policy.
- Membership:
- None.
- Insurance:
- No insurance needed.
Why it ranks here: The lowest flat pricing in the category at $99 and $125 with every dose the same, plus a prominent and correct disclosure that its compounded medication is not FDA-approved. Ranked here rather than higher because it publishes neither a refund policy nor its pharmacy partners.
- Membership:
- No separate fee.
- Insurance:
- Not stated.
Why it ranks here: States 503A licensed pharmacy sourcing and charges a flat $129/mo across all four microdose variants with no membership. Weigh that against microdosing being an off-label regimen with limited published evidence.
- Membership:
- None.
- Insurance:
- Not stated.
Also considered
- Fridays — States it does not manufacture compounded medication and sources it from regulated pharmacies, with the deepest coaching package here — but the best rates need a 12-month commitment.
- Aspire Health — Unusually candid terms — consultation fees non-refundable after clinical review, medication sales final once shipped, no guaranteed lab turnaround. Per-vial pricing makes comparison harder.
- Shapely — Compounded from $99/mo, but its actual strength is pursuing insurance coverage for brand-name medication first. Four states only.
- Citizen Meds — Not ranked. Billing every 23 days, automatic dose escalation by default, and no published pharmacy, eligibility or lab policy.
Frequently asked questions
What should I ask a compounded GLP-1 provider before signing up?
Four things: which pharmacy compounds the medication and is it 503A or 503B; what the price will be at your expected therapeutic dose, not the starting dose; how often you will be billed; and what happens to your money if you cancel before or after the order ships.
Is 503B better than 503A?
They are different models. 503B outsourcing facilities register with the FDA, are subject to federal current good manufacturing practice requirements and are inspected on a risk-based schedule. 503A pharmacies compound against individual prescriptions under state board of pharmacy oversight. 503B generally carries more federal oversight, but a well-run 503A is not inherently unsafe.
Is compounded semaglutide still available after the shortage ended?
Availability has become unstable. The FDA declared the semaglutide shortage resolved in February 2025, and some platforms have withdrawn compounded semaglutide entirely — Sesame states it is not currently available and QuickMD states it is no longer available due to FDA regulations. Others continue to offer it. Confirm before committing to a long plan.
What are the actual risks of compounded GLP-1s?
The FDA does not review compounded products for safety, effectiveness or quality, and has warned about fraudulent compounded semaglutide and tirzepatide carrying false label information. Eli Lilly has warned about an impurity found in some compounded tirzepatide containing vitamin B12. Formulations frequently include additives such as B12 or glycine that are not present in the approved products.
Keep comparing
Medical disclaimer
This page is general information, not medical advice. GLP-1 medications are prescription drugs with serious potential risks and are not right for everyone. Talk to a licensed healthcare professional about your own medical history before starting, stopping, or changing treatment. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality. Pricing and policies change frequently — confirm current details with the provider before purchasing.
Date reviewed: August 3, 2026