Basics
Drug Safety and Quality: Compounded Drugs
Health Care
Published on August 13, 2025
Explore This BasicMore than 60% of adults in the United States use prescription drugs to address health issues. With chronic conditions rising and a reliance on pharmaceutical options to treat them, ensuring drug quality and safety is paramount to protecting more than 130 million adults. While the Food and Drug Administration (FDA) has strict standards in place to ensure pharmaceutical quality and safety, bad actors can often find loopholes and ways to circumvent regulations.
Recently, counterfeit drug production and distribution have increased. This trend has led to serious issues for patients who may unknowingly consume unregulated dosages, illicit ingredients, and non-sterile pharmaceutical products. Counterfeit pharmaceuticals are untested and often take advantage of the gray area of reselling. Recent reports suggest the problem is particularly prevalent in the obesity and diabetes medication markets, with illegal actors selling more than 730,000 counterfeit medications a month.
Some suggest compounded drugs are at a higher risk of counterfeit production. These drugs are custom-made for patients with specific clinical needs by mixing or altering ingredients to meet specific patient needs. While compounded medicines help fill a needed gap, they are not FDA-approved and not held to the same safety and efficacy standards as FDA-approved pharmaceuticals.
Link to Additional Resources
- Brookings report – The Wild East of Semaglutide
- Food and Drug Administration – Counterfeit Medicine
- Food and Drug Administration Matters – A Dangerous Idea: Two Drug Manufacturing Pathways–One Regulated, One Not
- George Karavetsos and the Partnership for Safe Medicines – Knockoff Weight Loss Drugs From Illegal Foreign Sources
- Michael Gabar & National Library of Medicine – The Drug Quality and Security Act
- National Academies of Sciences, Engineering, and Medicine – Compounded Topical Pain Creams: Review of Select Ingredients for Safety, Effectiveness, and Use.
- National Association of Attorneys General – Letter Addressed to Acting FDA Administrator on Illicit Counterfeit Drugs
- National Library of Medicine – Safety of Compounded Medication
- Pew Trusts – US Illnesses and Deaths Associated With Compounded or Repackaged Medications 2001-2019
- The Hill – Compound medicine regulation is key to patient safety
- The Partnership for Safe Medicines – Patients face safety risks with counterfeit and compounded prescription weight-loss drugs
- United States Department of Justice – Fungal Outbreak 2012
- United States House of Representatives – AGRICULTURE, RURAL DEVELOPMENT, FOOD AND DRUG ADMINISTRATION, AND RELATED AGENCIES APPROPRIATIONS BILL, 2026
- United States Senate HEALTH, EDUCATION, LABOR, AND PENSIONS COMMITTEE – The New England Compounding Center and the Meningitis Outbreak of 2012: A Failure to Address Risk to the Public Health
- Vanity Fair – Why Counterfeit Ozempic Is a Global-Growth Industry
- World Health Organization – Substandard and falsified medical products