Eli Lilly warned that compounded versions of tirzepatide-based products that include vitamin B12 additives may introduce safety risks, highlighting impurity and formulation concerns as telehealth firms and compounding pharmacies expand GLP-1 access. Separately, reporting shows telehealth and compounding providers are exerting pricing pressure on brand manufacturers by offering lower-cost alternatives. Lilly’s advisory emphasised product integrity and patient safety amid a fragmented supply chain; the company and regulators have increased scrutiny on non-standard formulations. Industry reporting notes that compounding competition has undercut pricing for Novo Nordisk and Lilly, prompting legal, regulatory, and corporate responses from brand developers. Clarification: Compounded drugs are customized formulations prepared by pharmacies or compounding facilities and are not FDA-approved standard products; they can pose impurities or dosing inconsistencies compared with approved manufacturing.