The Mississippi Board of Nursing (MBN) just waded into the GLP-1 compounding debate, and for once, it’s not an outright shutdown. Instead, the board has issued a temporary rule that puts some compliance guardrails in place. The guidance raises questions about whether this could be the beginning of a more structured, sustainable future for compounded GLP-1s.
For now, the rule, which runs through May 30, 2025, requires that any nurse prescribing or administering compounded semaglutide or tirzepatide must verify that the pharmacy supplying it has either:
Sourced the active pharmaceutical ingredient (API) from a U.S.-based repackager or wholesaler that has verified the supplied certificate of analysis (COA),
OR
Conducted its own API verification testing to confirm the supplier’s COA.
At first glance, this could look like another barrier to access, but it might not be a bad thing. In fact, it could be a sign that regulators are looking for ways to let compounding stay in the game, just with more oversight. And that’s worth talking about.
A Middle Ground?
For the last year, compounded GLP-1s have been caught in regulatory limbo. On one side, patients rely on them as a more affordable and accessible alternative to brand-name options. On the other, the FDA and drugmakers argue that without tight oversight, there’s no guarantee of quality or safety.
Mississippi’s rule doesn’t shut down compounding. Instead, it lays out a basic expectation: If a pharmacy is going to compound GLP-1s, it needs to provide assurances to the prescriber that verify the quality of its API. That’s not an unreasonable ask, and some compounders are already doing this. But for those who aren’t? This rule might be a nudge toward higher standards, rather than an outright restriction.
And here’s where the conversation gets interesting...Should compound users see this as a sign of legitimacy? If states start recognizing compounded GLP-1s as a viable option (with proper safeguards), could that actually be a win for patients?
What Does This Mean for Patients?
Mississippi is just one state, but if others follow suit, it could shape the future of compounded GLP-1 access. For patients relying on compounded semaglutide or tirzepatide, this raises important questions:
Could tighter regulations actually secure the future of compounding, making these meds more trusted and widely accepted? Or is this just the first step toward stricter rules that could cut off access altogether?
Rather than another roadblock, this might be the beginning of a conversation about what responsible compounding looks like. If states start requiring quality control measures instead of banning compounding outright, that’s a shift worth paying attention to.
For now, the Mississippi rule is temporary, but it sets a precedent. What happens next depends on whether compounders, regulators, and patients can find a middle ground that ensures safety and access.
With the still high price many are paying for compounds, shouldn't there be some level of confidence in the safety and potency of the product they are injecting? What do you think? Is this a good thing for compound users?
Let me know what your thoughts are!