Skim the pharma news outlet of your choice, and it’s clear that compounding pharmacies have been making headlines. These pharmacies typically provide one of three things: prescriptions for off-label drug uses, medications that are not commercially available, or alternative formulations of existing drugs. Compounding pharmacies continue to gain traction with consumers thanks to direct-to-consumer marketing strategies. However, the pharma industry is striking back. Industry stakeholders are working to protect their intellectual interests and limit compounding pharmacies’ ability to produce and sell drug formulations that are deemed too similar to existing drugs — drugs that have been rigorously tested and approved by the FDA.
Read on for a quick primer on the rise of compounding pharmacies, as well as the ever-evolving conflict with traditional pharmaceutical organizations.
Understanding the Rise of Compounding Pharmacies
Harvard Health Publishing defines compounding pharmacies as “any pharmacy that provides medications that are not commercially available and prepares them onsite to meet [patients’] specific needs.” Compounded medicines are custom-made by pharmacists who combine or alter ingredients to mimic existing drugs. This isn’t necessarily a sinister or complicated process; for example, if a child cannot swallow a tablet or capsule, a compounded medication may be created in liquid form for easier drug administration. However, compounding pharmacies are seeing a major profit boom from lower-cost alternative formulations of popular drugs — particularly weight loss drugs, which remain in short supply. The shortage of these drugs has left a loophole open, in which the compounding pharmacies have been allowed to produce, promote and sell alternative formulations of these drugs. This has some pharmaceutical representatives speaking out.
Compounding Pharmacies Go “All In” on Ad Spend
The most recent example of the conflict between pharma representatives and compounding pharmacies occurred in a surprising place: the 2025 Super Bowl. One online compounding pharmacy debuted a weight-loss drug ad campaign during the football game, which is commonly recognized as the most-watched event on American television. Millions watched as the ad railed against “Big Pharma’s price-gouging” and drove consumers to the compounding pharmacy’s website. There, consumers can purchase compounded versions of popular weight-loss drugs — drugs that remain difficult to access in many traditional pharmacies — at lower prices. This sparked a heated response from numerous pharma representatives.
Compounding pharmacies are also utilizing social media to reach consumers directly. This may pose an additional concern for pharmaceutical representatives, particularly around the ethics of online advertising. One study published as a research letter in JAMA Health Forum concluded that digital advertising for compounded versions of a popular class of type 2 diabetes and weight-loss medications “commonly includes practices that only partially inform or even misinform consumers.”
Pharma Representatives Speak Out
Prior to the Super Bowl ad spot, the Partnership for Safe Medicines pharma group released a statement arguing that the ad “recklessly misleads and potentially endangers” viewers. The group’s key qualm with the ad? The fact that compounded drugs, like those advertised in the Super Bowl ad, are not subject to the same stringent FDA oversight required of traditional pharma outlets. “Typical pharmaceutical ads must follow strict guidelines about sharing a drug’s side effects and risks to inform and protect patients,” wrote Shabbir Safdar, the Partnership’s executive director. “Compounders operate on the outskirts of drug safety regulations and don’t face the same stringent requirements. This ad exploits the loophole in existing law, prioritizing shock value and sales targets.”
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Pharma representatives are striking back at compounding pharmacies; however, these nontraditional pharmacies may continue to gain traction, particularly as popular weight-loss drugs remain on the FDA shortage list. As long as these drugs remain on the list, compounding pharmacies will continue to prepare them, promote them, and sell them to the public.
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