The Human Toll of Removing Tirzepatide from the Shortage List: Voices from Those Who Rely on Compounded Medications

I’m sad that somewhere in a corporate boardroom, decisions are made that don’t reflect the struggles of the people who rely on life-changing medications. The FDA’s recent move to remove tirzepatide, the active ingredient in both Mounjaro and Zepbound, from its official shortage list has been hailed as a victory by many, but for those who depend on compounded medications, it feels like the rug has been pulled out from under them.

I’m sad that people like Kelly, a 55-year-old from West Virginia, may now face even more obstacles in their already hard-fought journey toward better health. Kelly had been considering weight loss surgery but found hope with Zepbound. She lost 28% of her body weight in nine months, and her health began to improve—not just physically but emotionally, too. The constant “food noise” in her mind quieted, her depression lifted, and even her arthritis pain eased. When the cost of her medications became unmanageable, compounded tirzepatide became her lifeline. But now, with tirzepatide no longer classified as being in short supply, Kelly’s affordable access to her compounded medication may be cut off.

I’m sad that these decisions overlook the human side of the equation. For people like Kelly, compounded medications are not a luxury; they’re a necessity. The removal of tirzepatide from the shortage list sends a message that everything is fine now, that brand-name Mounjaro and Zepbound are easily available to all. But the reality is starkly different. The high cost of these brand-name drugs keeps them out of reach for many, forcing people to turn to compounders who fill the gap.

I’m sad that Susan, from Ohio, who has struggled with ADHD and depression for years, is now uncertain about her future. When she discovered that her insurance wouldn’t cover brand-name tirzepatide, compounded medications were the only way she could afford to continue treatment. She finally started seeing improvements—not just with her weight but with her mental health. But now, like Kelly, she’s left wondering what comes next. Will her compounded medication still be available, or will new regulations make it harder for her to maintain the progress she’s fought so hard to achieve?

I’m sad that we’re not talking enough about the people whose lives are upended by these decisions. The FDA’s move to take tirzepatide off the shortage list might seem like a step forward on paper, but for those who rely on compounded medications, it feels like a door is closing. Compounding pharmacies have provided affordable access to these life-changing medications for people who otherwise couldn’t afford them. Now, that access may be taken away because of a decision that doesn’t reflect the lived reality of so many.

I’m sad for the thousands more with stories just like Kelly and Susan’s. People who have been relying on compounded versions of Mounjaro and Zepbound to find hope in their health journeys—people who, tonight, are feeling the weight of this decision press down on their hearts. These are the voices we don’t hear enough, the struggles that get lost in the shuffle of bureaucratic decisions and corporate interests. I’m sad for them tonight, and I hope that we start to hear their stories before it’s too late. What about them?

On the flip side, I’m also deeply grateful to Eli Lilly for taking the risk and developing tirzepatide in the first place. The effectiveness of Mounjaro and Zepbound has been nothing short of miraculous for so many. For those struggling with obesity—a disease that so often resists all efforts to fight it—these medications have helped fix what is biologically broken, allowing people to finally capitalize on their years, or even decades, of white-knuckled effort. These are people who have tried every diet, every exercise plan, every possible way to defeat obesity, only to face the frustration of their bodies fighting them every step of the way. Tirzepatide has changed that. For many, it has restored hope.

I’m sad that the FDA’s decision will likely force many into a painful dilemma: choose between their health and their financial stability. When we talk about drug shortages, we need to remember that access to medication isn’t just about supply—it’s about affordability. Removing tirzepatide from the shortage list assumes that the brand-name versions of Mounjaro and Zepbound are available and affordable to all, but that couldn’t be further from the truth.

The people who rely on compounded medications deserve better. We must advocate for policies that don’t just address the technicalities of supply but also take into account the financial barriers that prevent so many from accessing the care they need. The FDA’s decision might look like progress on the surface, but for people like Kelly, Susan, and the thousands more facing the same challenges, it feels like a step backward.

For these reasons, On The Pen is now calling on Eli Lilly to #ReleaseALLtheVials. Releasing the higher strengths of the vials, and keeping the cost around what folks were paying for compound would throw a lifeline to the millions who are relying on compound medications. It will allow them to continue their care, and to continue to capitalize on the benefit that your drug has helped them obtain.

Stay tuned to OnThePen.com for more updates and in-depth analysis on the latest developments in weight loss and diabetes treatments. Sharing this article is a powerful form of advocacy that brings us closer to our goal of educating the masses and reducing the stigma of obesity. If you found this article insightful, please share it within your networks, especially in Facebook groups and Reddit forums dedicated to GLP-1 medications and diabetes management. Together, we can make a difference.