Compounded GLP-1 eligibility wizard

What the Compounded GLP-1 eligibility does

This page hosts a free 4-step wizard that gives you an educational read on whether you are likely to qualify for compounded semaglutide or tirzepatide. It asks four things in order: the US state you live in, which compounded medication you are considering, your insurance situation, and your reason for wanting a compounded version. It then shows a plain-language verdict with suggested next steps. It is not a diagnosis, an application, or a coverage decision — it is a rules-based quiz that reflects the post-2024 rule that compounded copies now need a medical-necessity exception, so you can walk into a conversation with a prescriber already knowing the right questions.

The wizard exists because of a specific rule change. After the FDA declared the semaglutide and tirzepatide shortages resolved in 2024, compounded copies of these drugs are no longer freely available the way they were during the shortage. They are legal now only when a medical-necessity exception applies. The tool encodes the two medical-necessity exceptions it treats as valid: an allergy or sensitivity to an inactive ingredient in the brand-name product, or a dose that is not commercially available as a brand-name product. If your reason is one of those, the wizard returns a 'likely eligible' verdict; if your reason is cost alone, it tells you cost by itself is not a strong legal justification.

The verdict is decided by fixed if-then rules, not by a model, a dataset, or any live legal lookup. State is checked against a short built-in list; medication, insurance, and clinical reason each steer you into one of a handful of pre-written outcomes. Whatever answer you get is the same answer anyone else with the same four inputs would get.

How to read your result

Read the verdict as a starting point for a prescriber conversation, not a decision. A green 'likely eligible' result means your stated reason matches one of the two exceptions the tool treats as valid (allergy to a brand-name inactive ingredient, or a dose not sold commercially) and your state is not on its restricted list — but a licensed prescriber still has to evaluate you and document that clinical rationale before any compounded prescription can legally be written. The tool cannot verify your allergy or your dose; it takes your answer at face value.

The amber verdicts are the ones worth slowing down on. If you selected cost as your only reason, the tool flags that cost alone may not meet compounding rules and points you toward brand-name cash-pay routes first. If your insurance answer is Medicare or Medicaid and your reason is not one of the two eligible exceptions or cost, it notes that compounded preparations are typically cash-pay and that copay cards cannot be used with those plans, while brand-name GLP-1s for diabetes may still be covered. A red 'likely not eligible in your state' result means your state is on the tool's restricted list, and that check overrides the other answers.

Treat every suggested next step as navigational. This site is affiliate-supported and does not sell, prescribe, or provide care — the links point you to comparison and directory pages so you can weigh providers yourself. Nothing here starts treatment or gets you prescribed.

What the result is based on

The result is computed entirely from your four answers run through fixed rules in the page's source. State eligibility is checked against a small hardcoded list (currently Indiana and Kansas, labeled illustrative in the code) rather than a live database of state pharmacy law, and that state check runs first — a restricted state produces the red verdict regardless of your other answers. The clinical-reason question is the one that otherwise flips the verdict: 'allergy or sensitivity to a brand-name inactive ingredient' and 'dose not commercially available' produce the eligible outcome; 'cost' produces a cautionary outcome; 'previously affected by shortage' and 'not sure' produce a 'discuss with a prescriber' outcome. Separately, a 'Medicare or Medicaid' answer to the insurance question routes you to a cautionary note, but only when your clinical reason is not one of the eligible exceptions and not cost.

The dollar figures you may see in the next-steps text — manufacturer cash-pay prices such as roughly $349/month for Zepbound via LillyDirect and $499/month for Wegovy Direct — are hardcoded strings in the tool, not live pricing. Verify current prices directly with the manufacturer program, since these change.

The built-in explainer defines the two pharmacy types the wizard references: 503A pharmacies compound against an individual prescription under a state board of pharmacy, while 503B outsourcing facilities compound in bulk under direct FDA oversight and GMP standards. Which type serves you affects quality controls and paperwork like a certificate of analysis.

What it cannot tell you

• It does not read live state law. The 'restricted state' check is a two-state placeholder list marked illustrative in the code, so a green or non-red result is not confirmation that your specific state permits compounded GLP-1 access — state pharmacy rules change and the tool does not track them.
• It cannot verify anything you enter. It accepts your stated allergy or 'dose not available' reason as true and returns 'likely eligible' on that basis; only a prescriber examining you can confirm whether a genuine medical-necessity exception applies.
• It does not check drug shortage status in real time. Selecting 'previously affected by shortage' does not produce an eligible verdict, because the shortage-era access route ended when the FDA declared the shortages resolved in 2024.
• It ignores dosage, weight, BMI, medical history, other medications, and prior authorization details entirely — none of those are inputs, so the verdict says nothing about whether a GLP-1 is clinically appropriate or safe for you.
• The prices and program names it cites are static text in the code and may be out of date; confirm them with the manufacturer before relying on any figure.
• It only covers compounded semaglutide and tirzepatide. It does not evaluate brand-name-only questions, other GLP-1 molecules, or non-GLP-1 weight or diabetes medications.