How we audit compounding pharmacies.

A compounding pharmacyis a state-licensed pharmacy authorized under FDA 503A (patient-specific compounding under a prescription) or 503B (outsourcing facility, bulk compounding for healthcare facilities) to prepare prescription medications from active pharmaceutical ingredients. In the GLP-1 category specifically, this means semaglutide and tirzepatide formulations dispensed against a clinician's prescription — not the research-grade material the rest of vialaudit covers.

This is a different buyer-risk surface from the research-peptide vendor desk. The research side audits grey-market vendors selling material labelled for laboratory use only; the risk is identity fraud and purity. The compounding side audits regulated pharmacies dispensing under a script; the risk is inspection history, sterility practice, and the legitimacy of the telehealth prescription that authorized the fill.

We run this as a parallel desk, not an annex. Different rubric (this page), different URL surface (/pharmacies), different leaderboard, no cross-rubric comparison tables. A pharmacy and a research vendor are not the same product and we will not score them against each other.

Every established review site in this category — Sema vs Tirz, GLP1Files, SeekPeptides, GLP1Match, ClearMetabolic — earns affiliate revenue from the same pharmacies they rank. The vialaudit firewall only holds if the desk commits to harder constraints than it does for research vendors. The six concrete commitments below are stricter than the research-side firewall on /methodology by design.

1. 01

   Per-page disclosure on every pharmacy profile

   Not just an inline strip at the bottom. State the affiliate-program relationship, per-conversion economics if known, and whether the pharmacy acquired the placement before or after the audit was published. The research-vendor side states the relationship; the compounding side states the timeline of the relationship too.

2. 02

   Quarterly weight freeze

   The methodology page for compounding pharmacies is append-only within a quarter. If a rubric weight changes mid-quarter, it is a corrections-log entry, not a silent revision. Readers can re-derive any score from the version of the rubric in force at the audit date.

3. 03

   No paid placement

   No featured-pharmacy slot, no rubric-adjacent sponsorship, no "sponsored audit." Affiliate links route through `/go/` redirects identically to the research-vendor side; the editorial position cannot be bought, and the score is mathematically independent of whether an affiliate link exists.

4. 04

   Public-record floor for the verified chip

   No pharmacy receives a "verified" chip without at least one independently linkable public-record citation: a state pharmacy license number, an FDA inspection record, a PCAB accreditation directory entry, or an NCPDP number. Self-reported facts do not count.

5. 05

   Two-rail conflict logs

   If a pharmacy has both an active affiliate relationship with vialaudit AND a state-board action against it in the last 24 months, the inline disclosure must surface that conflict explicitly — the same way the research-side /legit pages surface coupon-aware pricing offsets.

6. 06

   Vendor-relationship denominator on /disclosure

   The /disclosure page carries a count: "vialaudit publishes affiliate links for N of M audited pharmacies; audit scores are mathematically independent per the rubric on /methodology/compounding." The denominator forces the relationship rate to be visible alongside the absolute count.

The compounding category is more profitable per-conversion than the grey-market side. The desk has to over-collateralize the trust position to keep its independence credible.

Score range is 0–10, weighted composite, same shape as the research-vendor leaderboard so the gauges read identically. FDA inspection history and state-board enforcement together account for 35% of the score — heavier than research-side purity at 40% by design, because in this category the analytical-purity question is partly outsourced to the FDA registration regime, and what differentiates good from bad is enforcement history and sterility practice.

• State pharmacy licensure footprint

  15%

  How many states the dispensing pharmacy holds active non-resident licenses in, with verifiable license numbers we can pull from each state's Board of Pharmacy directory. A pharmacy shipping to states it does not hold licenses in is a hard fail before any other dimension is scored.

• FDA inspection and 483 history

  20%

  Last five years of FDA Form 483 observations, warning letters, warning-letter closeouts, voluntary recalls, and consent decrees against the dispensing pharmacy (or its named partner pharmacies, if the audited entity is a telehealth distributor). The single heaviest dimension on the rubric.

• State-board enforcement actions

  15%

  Disciplinary actions, fines, consent orders, or license suspensions against the dispensing pharmacy or its pharmacist-in-charge, pulled from state board disciplinary databases. FDA + state enforcement together account for 35% of the score — the regulatory frame is the audit substrate.

• Sterility / USP <797> & <800> compliance

  15%

  Published environmental-monitoring data, media-fill records, BUD (beyond-use-date) policy alignment with USP <797>, and PCAB accreditation status. Sterility evidence is what stands in for the HPLC-MS purity test we run on research-grade material.

• Prescriber legitimacy and telehealth model

  10%

  Whether the consult is async-form or synchronous video, multi-state physician licensure of the named prescriber where one is disclosed, intake refusal rate when published, and good-faith examination compliance per state. We do not surface a named prescriber without the pharmacy's confirmation (see § 05).

• Ingredient sourcing transparency

  10%

  API (active pharmaceutical ingredient) supplier disclosure, wholesaler tier, and whether the upstream API manufacturer is an FDA-registered establishment. Pharmacies that publish their sourcing dossier score higher than pharmacies that decline to.

• Price transparency

  5%

  Published price vs visible upsells, multi-month commitment friction, cancellation friction, and whether a refund policy is written and accessible without contacting support.

• Buyer experience

  5%

  Trustpilot rating and review volume as a tiebreaker only, Reddit consensus where verbatim quotes are sourceable, and time-to-first-fill where reader reports converge. Explicit demotion of the customer-survey signal: in this category there are real regulators to read against, so survey data is not the score's center of mass.

• Buyer-protection chrome

  5%

  HSA acceptance, FSA acceptance, written refund policy, written grievance procedure, and BBB-accreditation status. The least-weighted dimension but a useful tiebreaker between otherwise comparable pharmacies.

A score of 9.0 or above means “clean enough that the regulatory trail is the verdict.” 7.0–8.9 is “works, with caveats — read the FDA + state-board sections before ordering.” Below 7.0 means the audit notes carry enough red flags that a careful read is required.

Pharmacies are scored at one of two tiers, displayed on every profile:

• public-data

  Public-record audit

  Scored from FDA databases, state board disciplinary records, PCAB directory entries, and the pharmacy's own published documentation. No first-hand consult or fill. Faster, lower signal, and explicitly marked on the profile so readers know what the score is built on.

• full

  Full audit

  Requires a first-hand telehealth consult placed under an alias — not just a chart review off the pharmacy's website. We log intake friction, prescriber identity, the script issued, the fulfillment pharmacy disclosed (if any), and the buyer-protection chrome around cancellation and refund. Full audits supersede public-data audits on the same slug.

The category invites moves that look like trust signals but actually drag third parties or readers into the audit. We do not:

• Surface a named prescriber without the employer pharmacy's explicit confirmation that the prescriber works there and consents to being named in the audit.
• Accept paid placement, sponsored audit slots, or rubric-adjacent advertising of any kind.
• Compare a compounding pharmacy to a research-peptide vendor in the same table, gauge, or leaderboard. The rubrics are structurally different; pretending otherwise is a category error.
• Recommend a specific dose, formulation, or pharmacy for any individual reader. Nothing on this site is medical advice; the audit describes pharmacy practices, not the safety or appropriateness of a prescription for a given person.

v0 means there are still calls we have not finalized. We are collecting input from readers on each of the four below before they harden into policy. Send notes to tips@vialaudit.com with a subject line referencing the question number.

1. Q1

   Affiliate stance on this category

   Yes-with-stricter-firewall (current default), no-at-all (purer but lower revenue), or yes-but-time-boxed-until-the-503A-rail-closes further? We are collecting input from readers on which of these three the desk should formally adopt before any /go/ redirect ships for a pharmacy.

2. Q2

   Named-prescriber surfacing

   Surfacing named physicians with NPI lookups against state medical boards is one of the highest-trust moves available — and it also drags real people into the audit. We will not publish a named prescriber without the employer pharmacy's confirmation. Beyond that, we want reader input on where the line sits.

3. Q3

   Postmortem trigger

   At what specific point does a pharmacy with a pending FDA action move from `status: investigation` to `status: shutdown` on the audit? Defining the trigger before the fact, not after, is what makes the postmortem desk reproducible.

4. Q4

   Reddit-verbatim policy

   Quoting r/tirzepatidecompound verbatim is editorially powerful, but the subreddit's community owns the audience. We want to confirm our position on quoting (with link-back, no display-name surfacing, no DM solicitation) with readers from that community before profile pages cite individual comments.

The point of a 30-day public comment window is to absorb criticism before the rubric locks. Two channels are open:

• Editorial input on the rubric — email tips@vialaudit.com, or use the contact form. Substantive comments may be quoted (anonymously by default) in the v1 changelog.
• Public discussion— there is an open thread on r/tirzepatidecompound for community-level feedback on the weights and the editorial firewall. Comment there if the input is structural rather than specific to one pharmacy.

Material changes between v0 and v1 will be logged on /corrections with a dated diff, not a silent revision.