Will GLP-1 Compounds Become the Next Cash Only Medical Market?

It happened to cannabis. Is it about to happen to compounded GLP-1s?

In the United States, marijuana remains illegal at the federal level. That single designation, Schedule I, has done more than criminalize a plant. It has created an entire medical economy that exists in cash. Banks do not touch it. Credit card processors stay away. Stripe, Square, Visa, Mastercard, they all steer clear. Why? Because serving the cannabis industry runs them into trouble with federal regulation, even in states where it has been legal for years.

Now, here is where it gets interesting.

This week, a growing number of physicians came forward reporting letters from their electronic medical records vendor, Tebra. These letters were sent on behalf of Stripe, the payment processor. The message was simple but serious: confirm you are not prescribing compounded GLP-1s, or risk losing access to your electronic medical records.

So what happens if Stripe pulls out completely? Their policy is strangely vague, and enforcement seems a bit… willy nilly.

What if Visa and Mastercard start flagging compounded GLP-1 transactions as high risk? What if merchant services decide the FDA’s position on 503A compounding is too murky, too politically hot, or too exposed to liability?

With 503B compounded copies shut down through the FDA and solidified by court decisions, the only way to shut down 503A custom formulations would be legislation.

Or is it?

What if leverage was simply applied to credit card companies and merchant services? We could potentially be heading toward a future where custom compounded GLP-1s become a cash only medical market, not because they are illegal, but because the financial system decides they are not worth the risk.

Ask anyone in the cannabis space. This is not theoretical. It is the exact playbook that transformed a medical industry into a cash economy overnight. And the logic is strikingly similar.

This is not about safety. It is not about clinical outcomes. It is about pressure. Quiet, coordinated, financial pressure. And once the rails for processing payments disappear, access disappears with them.

If you are a doctor, ask yourself, what happens if you can no longer accept card payments for compounded medications?

If you are a patient, ask yourself, what will you do when your telehealth starts to require payment in bitcoin?

Pssssttt. Hey bitcoin holders. There were over 80 million compound prescriptions filled in 2024 per the OFA. A large percentage obtained online. Just saying.

While we are not there yet, you at least smell what I’m stepping in…