JAMA Secret-Shopper Study: Compounded Semaglutide and Tirzepatide Still Widely Sold
TL;DR: JAMA Health Forum (17 Jul 2026) found 75 US clinics still selling compounded semaglutide/tirzepatide after FDA's shortage exemption ended.
What Did the JAMA Health Forum Study Find?
On 17 July 2026, JAMA Health Forum published a cross-sectional "secret shopper" study led by Michael J. DiStefano and colleagues at the Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus.[1] Between August and October 2025, the team identified 103 weight-loss clinics and medical spas in Oklahoma and West Virginia advertising GLP-1 receptor agonists, then called each one posing as a prospective patient to confirm what was actually offered.[1]
Of the businesses contacted, 75 confirmed they were still selling compounded GLP-1 receptor agonists — 92.0% (69/75) offered compounded semaglutide and 86.7% (65/75) offered compounded tirzepatide, and one business offered an unnamed compounded triple-receptor agonist.[1] The finding is notable because, by the time the calls were placed, the FDA's shortage-based legal basis for compounding either drug had already closed.[2]
This is a market-persistence story, not a safety-testing study. The researchers assessed what clinics said on the phone and what licenses their suppliers held — they did not independently test the compounded vials for identity or purity. For our take on unregulated peptide sourcing generally, see our grey-market guide.
When Did the FDA's Compounding Exemption Actually End?
Compounding pharmacies can lawfully prepare a copy of an FDA-approved drug under Sections 503A and 503B of the Federal Food, Drug and Cosmetic Act while that drug is officially listed as being in shortage. Tirzepatide (Mounjaro, Zepbound) came off the FDA's drug shortage list in December 2024, and semaglutide (Ozempic, Wegovy) followed in February 2025.[2] The FDA then set 22 May 2025 as the date after which compounders could no longer distribute compounded copies of either drug under the shortage provisions, aside from narrow, documented-need exceptions such as an allergy to an inactive ingredient in the branded product.[2]
| Milestone | Date | Effect |
|---|---|---|
| Tirzepatide leaves FDA shortage list | December 2024 | 503A/503B compounding basis for tirzepatide starts winding down |
| Semaglutide leaves FDA shortage list | February 2025 | Same wind-down begins for semaglutide |
| FDA compounding cutoff | 22 May 2025 | Shortage-based distribution of either compounded drug becomes unlawful |
| Secret-shopper calls placed | Aug–Oct 2025 | 75 of 103 businesses still confirmed selling compounded product |
| Study published | 17 July 2026 | JAMA Health Forum, DOI 10.1001/jamahealthforum.2026.2207 |
Every call for this study occurred after the legal window for shortage-based compounding had closed — which is what makes the 92%/86.7% availability figures notable, rather than a routine snapshot of a still-permitted market.[1]
What Did the Study Find About Licensing and Formulation?
Beyond simple availability, the researchers probed two quality-control questions: whether the supplying pharmacies held active sterile-compounding licenses, and whether the products sold were straightforward copies of the approved molecule or contained additional ingredients.[1]
Sterile compounding licensure
Among 21 state-licensed compounding facilities for which licensure status could be confirmed, 19.0% (4 of 21) did not hold an active sterile compounding license at the time of the call.[1]
Additive-containing formulations
58.7% of confirmed sellers offered formulations with added ingredients beyond the base peptide — most often B vitamins (56.0%), plus L-carnitine and glycine in a smaller share of listings.[1]
Neither finding proves a specific vial was contaminated or mislabelled — this was a phone-based market survey, not laboratory testing. But both describe the exact variables HPLC identity/purity testing and a verifiable pharmacy license are meant to close off: unknown formulation and unverifiable provenance.[1]
How Does This Relate to the FDA's July 2026 PCAC Hearing?
It is a related but distinct story. This JAMA Health Forum study concerns Section 503A/503B compounding of two already-FDA-approved drugs after their respective shortage designations lapsed. The FDA's Pharmacy Compounding Advisory Committee, by contrast, is meeting on 23–24 July 2026 to vote on whether seven peptides that have never been FDA-approved for any indication — BPC-157, TB-500, KPV, MOTS-c, DSIP (emideltide), Semax and Epitalon — should be added to the 503A Bulks List at all.[3]
Read together, the two stories share a theme: US compounding-pharmacy oversight of both approved GLP-1 drugs and unapproved research peptides is under active scrutiny in July 2026, and enforcement appears to lag the rules themselves in both cases.[1][3] For the PCAC hearing's day-by-day agenda, see our hearing schedule guide.
Why Verified Sourcing Matters Regardless of Compounding Status
The gap this study documents — between a drug's legal compounding status and what is actually sold on the ground — is exactly what independent, batch-specific verification is designed to close. A compounding license and a molecule's shortage status describe the legal framework a seller should operate under; neither tells you what is actually in a given vial.
The practical takeaway mirrors our earlier BPC-157 grey-market coverage: regulatory status and verified purity are separate questions, and a change in one does not resolve the other. Only documentation tying a specific batch to a specific identity/purity result closes that gap directly.
What Should UK Researchers Take From This?
Sections 503A/503B, the FDA drug-shortage list, and the compounding-pharmacy market this study surveys are specific to the US prescription-drug supply chain for patient-specific dispensing. None of it changes the regulatory status of GLP-1 receptor agonist research compounds under UK law, or the Human Medicines Regulations 2012 and MHRA guidance that govern research-reagent supply in Great Britain and Northern Ireland.
Velox Peptides does not compound, prescribe or dispense medicines. We supply retatrutide and other metabolic-research compounds strictly as HPLC-verified in vitro research reagents, each with a batch-specific certificate of analysis available in our public CoA library — the identity and purity documentation a phone call to a supplier cannot substitute for.
These compounds are supplied as research reagents only. They are not medicines and have not been evaluated by the MHRA or FDA. Not for human or veterinary use. See our Research Use Policy and MHRA Statement.
References
- DiStefano MJ, et al. Availability of Compounded GLP-1 Receptor Agonists After FDA Shortage Resolution: A Secret Shopper Study. JAMA Health Forum. 17 July 2026. DOI: 10.1001/jamahealthforum.2026.2207. jamanetwork.com
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. fda.gov
- U.S. Food and Drug Administration. July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee. Docket FDA-2025-N-6895. fda.gov
- Healio. Compounded semaglutide, tirzepatide continued to be sold after shortages ended. 17 July 2026. healio.com
- US News & World Report. Compounded Ozempic, Zepbound Still Widely Available Despite End Of Drug Shortages. 21 July 2026. usnews.com
Frequently Asked Questions
What did the JAMA Health Forum secret-shopper study find?
Researchers from the University of Colorado Anschutz Medical Campus called 103 weight-loss clinics and medical spas in Oklahoma and West Virginia between August and October 2025 and confirmed 75 were still offering compounded GLP-1 receptor agonists. Of those, 92.0% offered compounded semaglutide and 86.7% offered compounded tirzepatide, months after the FDA's shortage-based compounding exemption had legally ended.
When did the FDA's GLP-1 compounding exemption actually end?
The FDA removed tirzepatide from its drug shortage list in December 2024 and semaglutide in February 2025. It then set 22 May 2025 as the deadline after which compounding pharmacies could no longer lawfully distribute compounded copies of these drugs under the shortage-based provisions of Sections 503A and 503B, except for patients with a documented clinical need for a different dose or formulation.
Were the compounded products found to be unsafe?
The study did not test the vials themselves; it assessed the businesses selling them. Among 21 state-licensed compounding facilities the researchers could verify, 19.0% (4 of 21) did not hold an active sterile compounding license at the time of the call. 58.7% of confirmed sellers offered additive-containing formulations, most often with B vitamins, L-carnitine or glycine added, which fall outside a straightforward compounded copy of the FDA-approved molecule.
How does this relate to the FDA's July 2026 PCAC peptide hearing?
It does not directly overlap. This study concerns 503A/503B compounding of already-approved drugs (semaglutide, tirzepatide) after a shortage ends, while the Pharmacy Compounding Advisory Committee's 23-24 July 2026 hearing concerns whether seven never-approved peptides (BPC-157, TB-500, KPV, MOTS-c, DSIP, Semax, Epitalon) should be added to the 503A Bulks List at all. Both stories illustrate the same underlying theme: US compounding-pharmacy oversight of peptide and GLP-1 products is under active scrutiny in July 2026.
Does this affect UK research-reagent supply?
No. The study concerns US retail compounding pharmacies and medical spas dispensing patient-specific prescriptions under Sections 503A/503B of the US Federal Food, Drug and Cosmetic Act. It has no bearing on UK research-reagent supply, which is governed by the Human Medicines Regulations 2012 and MHRA guidance. Velox Peptides supplies tirzepatide and related metabolic-research compounds strictly as HPLC-verified in vitro research reagents, each with a batch-specific certificate of analysis, and does not compound, prescribe or dispense medicines.