Oklahoma and West Virginia: A Secret-Shopper Study Found Compounded GLP-1s Still Being Sold After the Shortage
A secret-shopper study in Oklahoma and West Virginia between August and October 2025 found 75 businesses still selling compounded GLP-1s after FDA ended the shortages, and more than half added additives. It is a warning about where regulators and researchers are looking.
Key Highlights
- Researchers who secret-shopped businesses in Oklahoma and West Virginia from August to October 2025 found 75 selling compounded GLP-1s after FDA ended the shortages.
- 58.7% of them added additives to the product, according to the published summary.
- The study, published in JAMA Health Forum in 2026, shows that compounded GLP-1 sales are now the subject of academic enforcement-gap research, not only regulatory action.
- Clinics selling compounded GLP-1s should be able to document the pharmacy, the prescription and the clinical rationale for every patient.
What the Study Did
Researchers posed as customers to businesses in Oklahoma and West Virginia between August and October 2025 and recorded who was selling compounded GLP-1 medications after FDA had declared the national shortages resolved. According to the reported summary, they found 75 businesses selling compounded versions, and 58.7% of them added additives to the product.
Why the Timing Matters
FDA's position is that once a shortage ends, the basis for large-scale compounding of copies of the approved drug narrows. Compounders can still prepare patient-specific products in limited circumstances, such as where a prescriber documents a significant clinical difference, but selling a copy of the approved drug without that is the area regulators have focused on. A study showing continued sales in the months after the shortage ended is the kind of evidence that tends to precede enforcement.
What It Means for a Clinic
If your clinic dispenses or prescribes compounded GLP-1s, you should be able to answer for each patient: which licensed pharmacy filled the prescription, what the prescriber documented about why a compounded product is appropriate for that patient, and what the product contains. Marketing is part of the same exposure, because claims that a compounded product is the same as, or generic for, a brand-name drug are what regulators have cited in warning letters.
A Note on Sources
This post relies on a news summary of the published study. Read the original JAMA Health Forum article for the methods and the full results, and treat the figures as the study's findings in two states during a specific period, not a national estimate.
Disclaimer
This article is general educational information, not legal advice. State law changes and depends on the facts of a clinic's structure, so confirm the specifics with health care regulatory counsel in the state before you rely on them.
MedGrid MSO provides management services to independently owned practices; it does not practise medicine and does not direct clinical decisions. Requirements vary by state and by service, and change over time — nothing on this page is legal or medical advice. Talk to us or your own counsel before making a structural decision for your clinic.