Lately, compounding pharmacies have every right to feel like the late comedian Rodney Dangerfield. No respect.
Maybe you recall Dangerfield as a bumptious blowhard — the uncouth jokester from Caddyshack and countless stand-up routines. But behind the bug-eyed delivery and loosened tie was a sharp, disciplined professional who knew exactly what he was doing.
With GLP-1 wonder drugs in prolonged shortage, it’s been compounding pharmacies stepping up to ensure millions of patients had access. Yet in many ways, compounders remain as misunderstood as Dangerfield was. To some drugmakers, regulators, and even reporters, they’re fringe players in a system dominated by big pharma. Like Dangerfield, that caricature hides a deeper truth. Compounders fill critical gaps in care. They deserve better than a punchline.
It’s time they got a little more respect.
Copycats? Really?
Let’s talk about language. Reporters often describe compounded GLP-1s with loaded terms like “copycats” or “knockoffs” — as if they were fake handbags on a bedsheet in Times Square.
I get the appeal. Those words are punchy. Some journalists even admit their editors favor them as “grabbers.” But catchy isn’t the same as accurate. Language like that distorts the truth. It trivializes the medicine and delegitimizes the profession behind it. It’s not objective reporting.
Why not just call them what they are called in FDA guidance: “essentially copies” of approved drugs.
Let’s also be consistent. When pediatric amoxicillin was in severe shortage two winters ago, compounding pharmacies filled the gap. Sick children got the medication they needed because compounders prepared copies of the FDA-approved drug. And it’s funny: With no drugmaker profits at risk, no one called those “knockoffs.”
Compounded medications aren’t shady imitations. They’re prescription drugs made in labs regulated by state boards of pharmacy, using ingredients from FDA-registered suppliers. They’re created for individual patients in forms or dosages not available commercially. That’s why they’re not FDA-approved — because they’re not mass-manufactured.
“Unapproved” … and Essential
Drugmakers — and the sock-puppet groups that echo their talking points—use the term “unapproved” to give the false impression that compounded drugs are somehow dangerous because they haven’t gone through the FDA’s approval process. It’s a slick bit of spin. But here’s the truth: “Unapproved” doesn’t mean “unsafe.” If it did, nearly every hospital in America would be in trouble.
Hospitals rely on “unapproved” compounded medications daily, because often there’s no FDA-approved option available.
If you’ve had an IV in a hospital, there’s a good chance it was compounded. Hospitals also rely on compounders when commercial drugs are in shortage. A pharmacist at a major Chicago hospital recently told me they had more than 250 medications on their shortage list.
Among them? Oral methadone, vital for treating opioid-dependent newborns in hard-hit communities. Another: dexamethasone, essential for reducing brain swelling. When those drugs aren’t available, compounded alternatives are the only lifeline.
And it’s not just hospitals. One pharmacy I know compounds a liquid form of hydroxyurea for pediatric sickle cell patients, because the only FDA-approved version is a giant pill a five-year-old can’t swallow.
Or consider compounded glutathione, a preparation that was literally life-saving for firefighters who battled California’s wildfires last year. It too is an “unapproved” drug.
In these and many other cases, “unapproved” doesn’t sound reckless. It sounds like a necessity.
Compounding, Counterfeiting, and Conflation
The most dangerous tactic used to discredit compounding is conflation — lumping legitimate compounded drugs in with counterfeit and illicit substances. Counterfeit drugs are illegal, often manufactured overseas, and sold online by unscrupulous entities. Compounded medications, on the other hand, are prescribed by licensed clinicians, prepared and dispensed by licensed pharmacists, and regulated by state and federal agencies. One of these things is not like the other, right?
Drugmakers deliberately blur these lines to sow confusion and distrust. This not only undermines patient confidence, it may impede access to vital therapies for patients who rely on compounded medications to survive.
Filling Critical Gaps in Care
Compounded drugs were never meant to compete with brand-name products. They complement the pharmaceutical industry — filling gaps where commercial drugs are in short supply or, based on the judgment of a prescriber, inappropriate for a specific patient.
Is there a debate to be had about how GLP-1 compounding opportunism may cross the line into competition? Yes. Let’s have that debate. But let’s also acknowledge that misrepresenting compounded drugs puts patients at risk.
Time for Respect
It’s time for drugmakers, the media, and regulators to stop treating compounding like a punchline.
Compounded medications aren’t knockoffs. They’re not counterfeits. They’re legitimate, highly regulated therapies that fill real, often life-saving needs.
Like Rodney Dangerfield, compounding pharmacies may not always get the respect they deserve. But without them, a lot of patients would be out of options.
And that’s no joke.
