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Desk memo. Telehealth Growth Desk. April 25, 2025.
Subject: three days after the 503A window closed.
If you run a cash-pay GLP-1 program, the thing you built your patient list on changed this week. This memo is about what happens to the business, not the medicine. I am not a clinician, and nothing here is clinical advice.
What actually changed for compounded semaglutide?
FDA's page lays out the timeline (I first covered the announcement in The Semaglutide Shortage Is Over). The agency determined the semaglutide shortage was resolved on February 21, 2025. For compounding by state-licensed pharmacies and physicians (section 503A), it said it would not act on shortage-list-dependent violations until April 22, 2025, or the court decision date if later. For outsourcing facilities (section 503B), the date was May 22, 2025, with the same court caveat.1
The reason is simple. FDA states that when a drug shortage is resolved, it generally considers the drug to be commercially available.1 That is the foundation of the wind-down.
Why the dates matter to your operations
Different parts of a telehealth chain sit under different rules. The pharmacy you work with may be a 503A pharmacy, a 503B facility, or neither. Their date is not necessarily your date, and the page itself is updated as events unfold. Ask your pharmacy partner in writing where they stand (start with 503A vs 503B), and have your attorney read the current FDA page, not this one.
Who are the three patient groups you need to talk to?
Segment before you message. One email to everyone will land badly with at least two of the groups.
| Patient group | What they probably need to hear |
|---|---|
| Mid-treatment, progressing | What the options are, who their prescriber is, and what happens to their next shipment |
| Early in treatment | Reassurance, a clear next step and no pressure to decide in one email |
| Paused or dormant | A low-pressure check in, not a hard sell |
Who decides what happens to each patient
The prescriber. Not the marketing team, not the founder. Your communications can explain options and logistics. Any change to a patient's medication or dose is a clinical decision for a licensed prescriber who knows that patient. Build the message so it routes patients to that conversation rather than around it.
What should your patient messaging say, and not say?
Say what happened, what the options are, and what it costs. Say it before the patient finds out on social media.
Do say
- What changed, in one or two plain sentences, without blaming anyone.
- That the prescriber will review each patient's next step.
- The real cost of each path, including any consult fees.
- How to reach a human with questions.
Do not say
- That a compounded product is the same as an approved one, or better. FDA's reasoning rests on the approved drug being commercially available, so equivalence claims are the fastest way to attract the wrong attention.
- Anything that sounds like a guarantee of results or continued supply.
- Anything that pressures a patient to decide today.
What pricing options exist for the transition?
Here is where the business math lives. Novo Nordisk announced on March 5, 2025 that all doses of Wegovy would be available at $499 per month for cash-paying patients through NovoCare Pharmacy, with home delivery fulfilled by CenterWell Pharmacy. The release says eligible patients are those who are uninsured or commercially insured without obesity-medicine coverage.2
That number is a data point for your patients, not a price you control, and it is part of the shift I described in When Manufacturers Sell Direct. What you do control is your own fee structure.
Unbundle the care from the product
When the medication is sourced elsewhere, your value is the program: intake, prescriber access, follow up, check ins and support. Price that clearly and separately from the drug, because you are selling care, not a product. Patients accept a care membership far more easily when the medication cost is transparent and not hidden inside it.
- Map every service you provide beyond the prescription: consults, messaging, check ins, coaching.
- Set a monthly care fee that reflects those services alone, and list the medication cost as a separate line the patient pays to the pharmacy.
- Offer a clear path for patients who choose to leave. A graceful exit is better marketing than a trap.
- Put the pricing in writing before the patient commits, and keep the consent record.
How do you keep patients through the switch?
Retention in a transition is mostly about trust, and the drop-off pattern is the one in GLP-1 Patient Retention. The patients who stay are the ones who felt informed and respected. The ones who leave angry are the ones who learned from a pharmacy label or a competitor's ad.
What to watch in your data
Track three numbers weekly through the transition: how many patients replied to your message, how many booked a prescriber check in, and how many are still active 30 days later. If reply rate is low, the message is the problem. If check ins are low, scheduling is the problem. If active drops after check ins, pricing or product options are the problem.
Patients forgive change. They do not forgive surprises.
The ad side
If you advertise this program, review every claim and creative against the new reality before you spend another dollar. In my experience, the fastest way to lose an ad account is to keep running yesterday's promise. Pause anything that references the old product. Rewrite headlines around the care you provide. Keep claims you can prove and cut the rest.
A short checklist for this week
If you only have an hour, do these four things in order. Confirm in writing where your pharmacy partner stands. Ask your medical director which messages need clinical review before they go out. Draft one plain email and one short text for each patient group. Then pause or rewrite any ad, landing page or intake form that still describes the old product. Those four steps put you in a far better position than waiting for the dust to settle.
- PharmacyConfirm in writing where your partner stands
- Clinical reviewAsk your medical director which messages need review
- MessagesDraft one email and one text per patient group
- Old productPause or rewrite ads, pages and intake forms
This is educational content about business operations, not legal or medical advice. Consult your attorney and licensed prescribers about your specific situation.
If your telehealth growth plan needs a hard look before the next dollar goes out, talk to me through my telehealth page.
Keep building.Ekai
Questions people ask
When did FDA's enforcement grace period for compounded semaglutide end?
FDA declared the semaglutide shortage resolved on February 21, 2025. Its page gave state-licensed pharmacies and physicians (503A) until April 22, 2025, and outsourcing facilities (503B) until May 22, 2025, with dates tied to pending litigation.
What did Novo Nordisk announce for cash-paying Wegovy patients?
On March 5, 2025, Novo Nordisk announced NovoCare Pharmacy, offering all doses of Wegovy for $499 per month to cash-paying patients, with home delivery fulfilled by CenterWell Pharmacy.
How should a telehealth brand message patients during the transition?
Early, plainly and without implying equivalence between products. Explain what changed, what the options are, who decides clinically (the prescriber) and what the cost is. Never claim a compounded product is the same as an approved one.
Is this legal advice?
No. This is educational content about business operations. Your attorney and your licensed prescribers decide what is permitted and clinically appropriate for your practice.
Sources
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