GLP-1 legislation aims at the wrong folks

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OPINION – California lawmakers are being asked to advance legislation targeting compounded GLP-1 medications, framed as a response to a supposed “public health crisis” driven by “unsafe” and “unregulated” products.

If that sounds familiar, it should.

Versions of this bill have appeared in multiple states, marketed as crackdowns on counterfeiters and bad actors. In at least six states, lawmakers ultimately walked away after closer review.

Now the same playbook has reached California – but with a revealing twist.

California’s Board of Pharmacy was not meaningfully consulted during drafting. After reviewing the bill, the Board raised serious concerns. That alone should give legislators pause.

These proposals are pitched as patient safety measures. But when the very regulator responsible for protecting patients questions whether a bill improves safety at all, lawmakers should ask a basic question: What problem is this trying to solve?

The board’s concerns are not technical quibbles. They go to the heart of effective regulation.

One issue is uneven application. The bill targets state-licensed pharmacies – already among the most heavily regulated healthcare settings – while leaving other sites, such as physician offices and med spas, far less affected.

Selective regulation does not eliminate risk; it pushes activity into less-regulated channels.

The board also notes that it already observes patient safety issues in areas where its authority is limited. This bill does nothing to close those gaps. Instead, it imposes new requirements on entities the board already oversees.

That is not a safety solution. It is regulatory misdirection.

The bill’s enforcement structure presents another concern. Mandatory penalties – including per-dose fines and automatic license revocation – remove the board’s ability to evaluate facts and apply proportional discipline. That strips regulators of discretion and undermines due process.

Put simply, the bill weakens the regulator in the name of strengthening regulation.

It is also redundant. Many provisions duplicate existing federal law, USP standards and California regulations, layering on new requirements without evidence-based justification. The result is more cost and complexity – for regulators and pharmacies alike – without a benefit to patients.

These are not the objections of industry advocates. They are the concerns of the government’s own enforcement arm. That is not what a well-constructed patient safety solution looks like.

Stepping back, a broader pattern emerges.

Yes, there are real problems in the marketplace: illicit sellers, counterfeit products and online operators far outside the healthcare system. There are also settings beyond pharmacy regulators’ reach where practices may legitimately raise concern.

Those actors should be investigated, prosecuted and shut down. But they are not state-licensed compounding pharmacies.

Pharmacy compounding operates within a well-established framework of federal and state law. These are licensed healthcare providers preparing medications pursuant to prescriptions for individual patients whose needs, in the informed judgment of a prescriber, are not met by commercially available drugs.

That is not a loophole. That is the law.

Patient experience further undermines the bill’s premise. In a February 2026 Zogby survey of 2,000 adults, users of compounded GLP-1 medications reported satisfaction and perceived effectiveness slightly higher than those using FDA-approved versions.

So, when lawmakers are warned that compounded GLP-1s are flooding the market with unsafe ingredients, a serious policymaker should ask: Where is the evidence that state-licensed pharmacies are responsible?

That question remains unanswered.

Everyone agrees on the goal of protecting patients. But AB 1990 uses that shared objective as cover – imposing duplicative barriers on lawful compounding while leaving higher-risk actors comparatively untouched. The result is fewer options for patients, steering care toward a single commercial channel even when a customized medication may be clinically appropriate.

That is not precision policymaking. It is collateral damage dressed up as consumer protection.

Demand for GLP-1 therapies exposed long-standing access gaps and the need for individualized care. Pharmacy compounding exists to meet those needs.

Legitimate policy conversations are needed – about marketing practices, guardrails and consistent standards. But those conversations should begin with regulators, not bypass them, and they should target bad actors without burdening lawful care.

California lawmakers should take the Board of Pharmacy’s concerns seriously. They should ask whether AB 1990 addresses real regulatory gaps – or simply creates new ones – and consider who is affected, and who is not.

If a bill leaves counterfeiters and unregulated actors largely untouched while making it harder for licensed pharmacies to serve patients with valid prescriptions, then it is not a patient safety bill.

It is something else.

And legislators should recognize the difference.

Scott Brunner, CAE, is chief executive officer of the Alliance for Pharmacy Compounding.