# How Many People Use Compounded GLP-1 Drugs? Records Catch 8.2% | This GLP Compounded GLP-1 use was documented in 8.2% of 153,044 primary care patients, against about 23% in surveys | a compounded prescription leaves no structured record. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/how-many-people-use-compounded-glp1-drugs Updated: 2026-09-18 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # How Many People Use Compounded GLP-1 Drugs? Records Catch 8.2% Primary care records documented compounded use in 8.2% of 153,044 patients, against about 23% in surveys. A compounded prescription leaves no structured record, so the true share cannot be counted. [This GLP Editorial Team](https://thisglp.com/about)September 20266 min readUpdated September 2026 Where each number came from · Brand name: · structured records · Compounded: only · free-text notes · 8.2% of 153,044 patients documented as compounded. · Counted only where a clinician wrote a sentence about it. · That makes 8.2% a floor, not a rate. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - No reliable count exists. Medical records capture only the compounded use a clinician wrote down. - In 153,044 US primary care patients on semaglutide or tirzepatide, 8.2% had compounded use documented, from 2021 through 2024. - Surveys cited by the same authors put the share near 23% of users, well above the documented figure. - A second records study found compounded use often appeared in notes before the first structured prescription. - In one state in 2024, 93 business websites advertised compounded GLP-1 drugs from 188 physical locations. Nobody has a reliable count. The largest records study found compounded semaglutide or tirzepatide documented in 8.2% of 153,044 US primary care patients using those drugs [\[1\]](https://thisglp.com/research/how-many-people-use-compounded-glp1-drugs#ref-1). Surveys cited by the same authors put the share near 23% of users. The gap is the point. A compounded prescription does not create the record a brand-name one does. It appears in a chart only if a clinician writes it down. The same visibility problem runs through the sellers themselves. What they leave off their pages is counted in [what GLP-1 sellers do not publish](https://thisglp.com/research/what-glp1-sellers-do-not-publish). ## What the medical record catches Hendrix and colleagues used a national database of primary care records [\[1\]](https://thisglp.com/research/how-many-people-use-compounded-glp1-drugs#ref-1). The window ran from January 2021 to December 2024. Brand-name prescriptions came from structured data. That means the coded fields every system records automatically. Compounded use could not be found that way. It was found in clinical notes instead: free text, typed by a clinician. So 8.2% is not the share of people using compounded drugs. It is the share whose clinician recorded it. A buyer who never told their doctor is not in it. Neither is one whose doctor did not write it down. The authors conclude that many patients may get these drugs outside coordinated care. Longer on treatment is not better treatment Compounded-only patients stayed on treatment 10.0 months on average. Brand-name-only patients stayed 7.8 months. That is an association in retrospective data. Cost and refill mechanics can produce it. It is not evidence that compounded drugs work better. The documented users also differed. They were more likely to be female, non-Hispanic White and without diabetes. They were also more likely to live in less deprived areas. Their share of semaglutide and tirzepatide use rose over the study window. ## Reading the notes more closely A second study used a language model to read clinical notes at scale [\[2\]](https://thisglp.com/research/how-many-people-use-compounded-glp1-drugs#ref-2). It covered a US records platform of over 29 million patients. It found compounded exposure in 1,696 patients who started treatment without a documented barrier. For about half of them, the first compounding signal came on or before the first structured prescription. That was 50.8% for semaglutide and 57.9% for tirzepatide. The same study shows why structured records mislead in general. Over 18 months, persistence on semaglutide was 55.4% by prescription records against 42.3% by the notes. For tirzepatide the figures were 58.3% and 43.1%. How long people really stay on these drugs is covered in [what happens when they stop](https://thisglp.com/research/stopping-glp1-and-weight-regain). ## Counting sellers instead of users The supply side is easier to count than the buyers. DiStefano and colleagues searched for websites advertising compounded GLP-1 drugs in Colorado in March and April 2024 [\[3\]](https://thisglp.com/research/how-many-people-use-compounded-glp1-drugs#ref-3). They found 93 businesses at 188 physical locations. Medical or health spas were the largest group, at 33. Weight loss services were next, at 26. Semaglutide was advertised by 92 of the 93. Tirzepatide was advertised by 40. Of the 93, 41 referred to FDA approval when describing compounded products, and 5 called them generic. This is a count of places selling, not of people buying. What a compounded vial changes about dosing is in [the semaglutide starting dose guide](https://thisglp.com/research/semaglutide-starting-dose). What a buyer should expect from a provider is in [the care standards comparison](https://thisglp.com/research/what-should-a-glp1-provider-actually-do). ## Frequently asked How many people use compounded GLP-1 drugs? Nobody has a reliable count. One study documented it in 8.2% of 153,044 primary care patients on semaglutide or tirzepatide. Surveys cited by the same authors put it near 23% of users. Why can't compounded use be counted from medical records? A compounded preparation does not create the structured prescription record that a brand-name drug does. It appears in the chart only if a clinician types a note about it. Do compounded patients stay on treatment longer? In one dataset, compounded-only patients averaged 10.0 months against 7.8 for brand-name-only. That is an association in retrospective data, and cost and refill mechanics can explain it. How many businesses sell compounded GLP-1 drugs? One state-level count has been published. A 2024 search in Colorado found 93 business websites advertising compounded GLP-1 products, at 188 physical locations. ## Sources 1. \[1\] Hendrix N, Velásquez EE, Pham H, Bazemore A (2025). Documentation of Compounded GLP-1 Receptor Agonists in a Large Primary Care Dataset Pharmacoepidemiology and Drug Safety. [PMID 41024632](https://pubmed.ncbi.nlm.nih.gov/41024632/) 2. \[2\] Varma G, Murugadoss K, Kurian ME, Varghese J, et al. (2026). Auditable large language model curation of clinical notes refines glucagon-like peptide-1 initiation, persistence ascertainment, and compounding use beyond prescription records Biology Methods and Protocols. [PMID 42433615](https://pubmed.ncbi.nlm.nih.gov/42433615/) 3. \[3\] DiStefano MJ, Dardouri M, Moore GD, Saseen JJ, et al. (2025). Compounded glucagon-like peptide-1 receptor agonists for weight loss: the direct-to-consumer market in Colorado Journal of Pharmaceutical Policy and Practice. [PMID 39776466](https://pubmed.ncbi.nlm.nih.gov/39776466/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. 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