Brand-name versions (Ozempic, Wegovy, Mounjaro, Zepbound) are FDA-approved, manufactured under strict regulatory oversight, and typically cost $1,000–$1,500/month without insurance. Compounded versions are made by compounding pharmacies — they're significantly cheaper ($200–$500/month) and were widely available during recent FDA-declared shortages. Important: as of 2025, FDA declared the semaglutide shortage resolved, and compounding under those rules is being phased out. Tirzepatide compounding is also under regulatory scrutiny. The FDA has issued warnings about quality control with some compounded versions. Ask any med spa exactly which formulation they use, where it's sourced, and whether it's currently compliant with FDA rules.