News//3 min
The compounding question, after the shortages
Compounded semaglutide filled a real gap during a genuine shortage. The regulatory basis for that gap has narrowed — and the market has not gone anywhere. Here is how to reason about it.
Practical
Compounding
The gray market, the FDA, and how to judge a source.
7 pieces
News//4 min
Buying direct: the new cash prices
Both makers now sell straight to patients, below list, outside the insurance machinery. For the uninsured it is the biggest practical change in years — and it quietly reprices the entire gray market.
News//3 min
Generic semaglutide, elsewhere
Patent expiry in several countries has produced generic semaglutide at a fraction of the American price. The US patent runs years longer, which is already driving people toward routes that carry real risk.
Deep Dive//5 min
Microdosing GLP-1s
Taking a fraction of the standard dose is now common enough to have its own vocabulary and its own influencers. Some of the reasoning is sound. Almost none of it has been tested.
Guide//4 min
What these drugs cost in America
List price, negotiated price, coupon price, cash price, compounded price. Five numbers, none of which is the price, and only one of which you will ever be quoted.
Guide//5 min
Judging a compounded source
There is a real difference between a licensed 503A pharmacy with a prescriber behind it and a website selling vials labelled 'not for human consumption'. Most people cannot tell them apart, and the marketing is designed that way.
Deep Dive//5 min
Inside the telehealth GLP-1 boom
A monthly fee, a fifteen-question form, and a prescription in under ten minutes. Some of these services provide genuinely good care. Distinguishing them from the ones selling access is harder than it should be.
Also in Practical
On The Jab
The
GLP‑1
Handbook
Dr. Nick Robertson
MD
The book · 14 chapters
The GLP-1 Handbook
Everything I tell my own patients before their first injection. 214 pages of what actually matters in the first year — dosing, side effects, food, muscle, cost, and the part nobody prepares you for: maintenance.
$4Less than your morning coffee.
Priced at four dollars because it should be affordable to everyone taking these drugs — not because it's worth four dollars. No upsell, no course, no supplement line.