Brand-name semaglutide

Manufactured by Novo Nordisk. FDA-approved as Ozempic (T2D), Wegovy (chronic weight management), and Rybelsus (oral T2D). Same molecule across brands; the difference is dose and indication.

503A compounded semaglutide

Prepared by a state-licensed compounding pharmacy under a specific prescriber order for a specific patient. Permitted under FDA enforcement discretion when a drug is on shortage and there is a clinical need. Not the same as a generic.

503B outsourcing facilities

Larger compounding operations that can prepare batches without patient-specific scripts but must register with the FDA and meet stricter cGMP standards.

What the price difference reflects

Brand pricing reflects manufacturer R&D, marketing, and patent economics. Compounded pricing reflects the cost of the API plus the pharmacy’s margin. Outcomes are not identical — review of compounded outcomes data is thinner.

Risk considerations

Stick with LegitScript-certified pharmacies. Avoid any provider that will not disclose the dispensing pharmacy. Avoid imported APIs of unknown provenance.