You can get these wholesale from China from "reputable" gray-market wholesalers who get the chemicals made at contract manufacturing facilities. BYO QA/QC though, as with all non-FDA drugs. That's the huge catch, and it sucks for consumers. Testing just for active ingredient is >$100 and takes about a month. Testing for proper buffering agents, harmful contaminants, microbial contamination, etc is essentially unavailable at all.

Semaglutide is very, very cheap in the gray market. It's somewhat less effective than Tirzepatide and has slightly more side effects if you ramp up the dosage too quickly.

If an annual amount is purchased on the gray market, this brings the monthly cost down to:

- Semaglutide: $10/month

- Tirzepatide: $60/month

- Liraglutide: $87/month

- LY3437943: I have not yet seen this available, but it looks like distributors are notifying manufacturer of latent demand and are working to build up a supply chain.

Note that in the USA, it is legal to import certain amounts of FDA-approved drugs if you have a prescription for them. However, just because something is the exact same chemical as an FDA-approved drug does not make it an FDA-approved drug. It must be manufactured in an FDA certified facility and be the same brand/manufacturer/packaging/labeling/etc as the approved drug.

e.g. importing generic Sildenafil/Viagra is legal if you can find the Teva(tm) brand generic sildenafil in, say, Mexico or Canada for a better price. But it must be the pills manufactured by Teva in the appropriate facility with NDC #0093-5342-56[0].

If you import generic sildenafil "Cenforce" from the (very legitimate but not FDA-approved) Indian pharmaceutical manufacturer "Centurion Laboratories"...

...that would still be potentially criminal smuggling. Even if the pills you import show via laboratory test that they precisely match your medical prescription, they are not "FDA approved" and therefore not legal to import.

A lot of people do though!

0: https://ndclist.com/ndc/0093-5342/package/0093-5342-56