Compounded GLP-1 Inquiry

Since 2022, many type 2 diabetes and weight-loss injectables (including, but not limited to, Weg***, Moun***, Oze***, Sax****, and Zep****) have been in national shortage. Over the past several months, we have received a surge of phone calls from concerned patients and providers seeking access to these essential medications—either because they cannot abruptly stop their current therapy or because they are looking to start new treatments.

As an independent pharmacy committed to helping our community navigate healthcare challenges, we sought alternatives to support our patients’ needs.

Lititz Apothecary has conducted due diligence on compounded GLP-1 medications from FDA-approved facilities and now has availability.

Cost:

o Injectable: Starting at $280 every 4 weeks, increased based on dosage

Overall Process:

Once you complete this form, an onboarding specialist will reach out and go over the details.

1. You may reach out to your Provider (doctor's office) AND the pharmacy will reach out to the provider as well (advocating on your behalf)

2. Once the prescription is received, we will contact you to set a time with a clinician to go over injection techniques, best practices, and other FAQ.

3. When you are due for a refill, our staff will contact you, 3-5 days in advance to go over your progress and prepare the next month's dosage.

Patient's Name

First NameLast Name

Patient Address*

Street Address

Street Address Line 2

CityState Initials

Postal / Zip Code

Date of Birth*

Email*

example@example.com

Cell Phone Number*

List name and city of Doctor/Provider who prescribes this type of medication for you*

Please indicate a few dates and times a specialist can reach-out to answer any questions and process?*

How did you hear about us?*

How would you like to receive the medication once it is ready?

Pick up in Person- No additional chargeDeliver/Ship it to me - $30 Fee

Any other information you would like to add?

I understand and acknowledge that I will have my prescriber send a script to Lititz Apothecary only if I am informed to do so. I understand and acknowledge that Lititz Apothecary can and will advocate on your behalf and have a clinical conversation with the prescriber. Lititz Apothecary will not be able to dispense medication without a valid prescription.*

Date Signed *

Date