The FDA declared the national semaglutide shortage “resolved” early in 2025, but patients across the U.S. would strongly disagree. Clinicians continue reporting week-long backorders, inconsistent supply, and insurance-driven delays. Pharmacies see demand spiking far beyond pre-2023 levels, and online searches for “GLP-1 alternatives” and “compounded semaglutide near me” have never been higher.
So if the shortage is “over,” why are patients still struggling to access GLP-1 medications?
The answer lies in a complex mix of demand, manufacturing capacity, prescribing patterns, and the unique role of compounding pharmacies in filling the gaps.
Let’s break down what’s really happening and what patients must know in 2025.
The FDA Declared the Shortage Resolved: But Demand Didn’t Drop
When the FDA updated its drug shortage database earlier this year, many expected the market to stabilize. But the opposite happened.
Demand for GLP-1 medications skyrocketed again.
Three forces shaped this:
- New clinical approvals and expanded indications
More physicians now prescribe GLP-1s for obesity, insulin resistance, metabolic disease, PCOS, and cardiovascular protection. - Social media influence
TikTok and Instagram propelled GLP-1s into mainstream culture, with billions of views under hashtags like #OzempicJourney and #GLP1. - Workplace and insurer wellness programs
Large employers added GLP-1 coverage, massively increasing eligible patient numbers.
The FDA shortage resolution only meant manufacturers were producing again, not that supply met demand.
For safety details on compounded alternatives, see Compounded GLP-1s in 2025.
Manufacturing Capacity Can’t Keep U – Even With Full Production
Novo Nordisk and Eli Lilly expanded facilities, but:
- They cannot build new factories fast enough
- Active pharmaceutical ingredient (API) production has global bottlenecks
- Vial and injector-pen manufacturing is limited
In other words:
2025 demand outgrew 2025 production.
And patients feel the impact daily.
Insurance Barriers Have Become the “New Shortage”
Even when medications are in stock, many patients can’t get them due to:
- Prior authorization delays
- Quantity limits
- Step therapy requirements
- Narrow formularies
- High out-of-pocket copays
These barriers effectively act as a shortage for thousands of patients.
This is why compounded GLP-1 demand surged, not because patients prefer it, but because they can access it.
Why Compounding Filled the Access Gap in 2025
1. Faster availability
Compounding pharmacies rely on pharmaceutical-grade semaglutide API, not limited injection-pen manufacturing lines.
2. Flexible dosing
Compounded GLP-1 allows:
- Microdosing
- Slow titration
- Allergen-free formulations
For allergy-related adjustments, see Allergy Drops vs Shots vs Pills (2025).
3. Patient-specific personalization
503A compounding is legally allowed when a patient cannot access commercially available versions.
4. Alternative delivery forms
Including multi-dose vials with safe documentation and traceability.
But compounding only works when patients choose verified, compliant pharmacies.
Learn how to identify them:
How to Evaluate a Compounding Pharmacy in 2025.
The “Shadow Shortage”: Unsafe Online Sellers Flooding the Market
As demand rose, so did illegal supply.
2025 saw a huge increase in:
- Fake semaglutide powder kits
- Counterfeit pens
- Misbranded vials
- Clinics offering medication without prescriptions
The FDA issued multiple warnings about salt-form semaglutide (semaglutide sodium, acetate) sold online as “GLP-1 base.”
These products:
- Do NOT match FDA-approved semaglutide structure
- Lack safety data
- Are often contaminated or under-dosed
- Can cause dangerous reactions
OutSourceWoRx explains sterile safety controls here:
503B Quality Control & Sterility.
Providers Are Turning Back to 503B Outsourcing Facilities
Hospitals and clinics increasingly rely on sterile outsourcing to ensure:
- cGMP-aligned production
- Lot consistency
- Environmental monitoring
- Third-party sterility and endotoxin testing
This is especially true for GLP-1 injectables used in clinics.
Why This Shortage Matters for Investors (CapitalWorx Insight)
The persistent demand–supply imbalance has triggered:
- Increased investment in compounding infrastructure
- Mergers and acquisitions in sterile outsourcing
- AI-driven QC automation
- New entrants in metabolic therapeutics
Capital Worx describes this shift as part of “The Post-GLP-1 Economy.”
Read more:
Compounding Market Outlook 2026–2030.
Final Thoughts: The Shortage Didn’t End. It Changed Shape.
Even though the FDA removed semaglutide from its official shortage list, patients, providers, and pharmacies all know the truth:
The shortage never ended, it simply evolved.
Today’s barriers include:
- Overwhelming demand
- Insurance restrictions
- Manufacturing limitations
- Counterfeit products
- Online misinformation
Compounding pharmacies, when chosen wisely, provide a safe, regulated pathway to access.
If you’re considering a compounded GLP-1, make sure you:
✔ Verify the pharmacy
✔ Check documentation (CoA, lot number, BUD)
✔ Avoid online “peptide kits”
✔ Work with a licensed provider
✔ Choose real, tested formulations
With proper oversight, compounded GLP-1s remain a critical tool for continuity of care in 2025, even as the shortage continues beneath the surface.