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Who makes the molecules, what they cost direct-from-manufacturer, what is coming, and what the compounding and generic landscape looks like.
Eli Lilly makes tirzepatide (Mounjaro and Zepbound) and runs LillyDirect, the most aggressive cash-pay channel in the GLP-1 category.
Novo Nordisk dominates the GLP-1 category by molecule. Semaglutide (Ozempic, Wegovy, Rybelsus) and liraglutide (Saxenda, Victoza) form the largest GLP-1 portfolio.
Compounded GLP-1s emerged during the 2022-2024 FDA shortage. The FDA declared the tirzepatide shortage resolved in December 2024 and the semaglutide shortage resolved in February 2025, and is enforcing 503A/503B rules more strictly. Compounded supply is contracting.
No FDA-approved generic GLP-1 exists in the US. Semaglutide patents expire 2026-2031 by country; US patent through 2031. Compounded preparations are not generics.