Safety group CSPI argues against peptides in JAMA before White House meeting

Also in this issue: Bankers put top med spa chains at 14-15x EBITDA

Tuesday, Oct. 27, 2026

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Take. Expect the peptide plan to come back with more conditions than sellers asked for. Every condition costs money, which favors big telehealth brands over single clinics. We'd hold peptide ad budgets flat until the text is public.

Peter Lurie and two colleagues at the Center for Science in the Public Interest published a JAMA Viewpoint on Monday. They urge FDA not to follow July's advisory committee votes on seven peptides. CSPI's release says approving them "would create a huge, largely unregulated market." It also says FDA's proposal at the White House "would apparently lead to non-enforcement of many FDA regulations." CSPI meets OIRA, the White House office reviewing the plan, today at 2:30 p.m.

Dr. Anant Vinjamoori, chief medical officer of Hims & Hers, made the selling side's case on X Friday. He wrote that he had "just wrapped a meeting with OIRA" on the plan. He added, "Countless Americans are already using peptides right now." Sen. Roger Marshall wrote FDA last Wednesday asking it not to enforce against compounding of some peptides, per the Alliance for Pharmacy Compounding. APC says his letter sets conditions. Ingredients would come from FDA-registered makers under drug-quality rules. Compounding would happen only at registered 503B outsourcing facilities or state-licensed 503A pharmacies, for an identified patient. FDA's advisory committee would keep reviewing safety. The letter itself has not been posted. A senator's letter is pressure, not law.

When (ET)	Who	Side	Status
Wed 10/21, 3 p.m.	American Academy of Peptide Medicine	Selling	Met, nothing posted yet
Fri 10/23, 2 p.m.	Hims & Hers	Selling	Past, Hims's CMO posted on X
Tue 10/27, 2 p.m.	Alliance for Pharmacy Compounding	Compounders	Today
Tue 10/27, 2:30 p.m.	CSPI	Safety	Today
Wed 10/28, 3 p.m.	Faegre Drinker for CEBM	Safety	Wednesday
Wed 10/28, 3:30 p.m.	Carmen Group for Medivant, a 503B	Compounders	Wednesday

FDA sent the plan to OIRA on Oct. 14 as a notice-stage Interim Access Policy, not a rule, per OIRA's meeting log. Review runs 90 days, to about Jan. 12, with one 30-day extension possible. No meeting materials have posted. Even a friendly plan won't settle the ad question. LegitScript, which ad platforms use to vet pharmacy advertisers, wrote in September that "only a final rule actually changes the regulatory status" of a substance.

The Signal

Medspa

Bankers put top med spa platforms at 14 to 15 times EBITDA

Private equity firms that built med spa and GLP-1 clinic chains face their first real exits in 2027, PitchBook reported Friday. A banker quoted in the piece says buyers get serious at $15 million to $20 million of EBITDA. A strong platform could fetch 14 to 15 times pro forma EBITDA if four numbers are all growing: same-store sales, patient count, ticket size and provider retention. Cascadia Capital's Josh Mastracci says PE money is moving to cash-pay models run by mid-level providers "with less regulatory exposure." Thurston Group may sell Alpha Aesthetics Partners, a 37-location chain, as soon as 2027. The biggest ask hasn't cleared. LaserAway sought more than $2 billion on about $150 million of EBITDA, per an earlier PitchBook report. That sale process is no longer active. We think buyers will pay the top multiple only for chains growing on all four counts.

Telehealth

Judge refuses to revive Strive's suit over Lilly and Novo telehealth deals

Strive Specialties, a compounding pharmacy, sued Eli Lilly and Novo Nordisk in Texas in January. It argued their exclusive telehealth deals shut out compounded GLP-1s. Judge Micaela Alvarez dismissed that claim in August. The court ruled on Strive's request to reconsider on Friday, per the docket. Law360 reports the judge denied it, saying Strive's argument rested on its "own misunderstanding." No appeal has been filed. The drugmakers' deals with telehealth brands stand.

Everyone

HHS's health IT office drops certification rules for EHR software

The Office of the National Coordinator for Health IT certifies the electronic health record software that practices need for some Medicare programs. Its new final rule removes or revises a set of those certification criteria, per the Federal Register inspection copy. ONC puts the savings at $2 billion in present value, or $108 million a year, mostly for software vendors. The rule publishes Wednesday. Most of it takes effect in late December. Most cash-pay clinics don't use certified software.

Prescriber

FDA clears three orforglipron makers to export to the US

FDA's import alert now lets in orforglipron, the drug in Lilly's Foundayo pill, from three makers it added this month. Mochi's site lists a compounded version "as low as $31."

The Price Board: cash GLP-1 prices

Semaglutide per month

4 of 80 prices shown

ODR Price Board optimized.news, checked Oct. 28, 2026

All-in totalMedicineMembershipAll-in median

Seller	Per monthAll-in median $175	Read
OurView HealthSemaglutideCompoundedMedication, online consultation, shipping options	All-in $109 , lowest third	Oct. 28
Medicine, listed $109/mo Membership, listed None Intro or offer None Membership per month None All-in, 3-month average $109/mo All-in from month 4 $109/mo How we got it Medicine $109/mo (normalized from seller billing cadence) = $109/mo Basis Derived Source ourviewhealth.com/personalized-glp-1 Read Oct. 28, 2026 Pricing varies by offer; this is our calculation from the seller's public page.
Lumen MedsSemaglutide + B12 programCompoundedDoctor visit, free expedited cold shipping	All-in $115 , lowest third	Oct. 28
Medicine, listed $115/mo Membership, listed None Intro or offer None Membership per month None All-in, 3-month average $115/mo All-in from month 4 $115/mo How we got it Medicine $115/mo = $115/mo Basis Listed Source lumenmeds.com Read Oct. 28, 2026 Pricing varies by offer; this is our calculation from the seller's public page.
StallionSemaglutide injectableProvider access, medication, lab work, free shipping	All-in $169 , middle third	Oct. 28
Medicine, listed $169/mo Membership, listed None Intro or offer None Membership per month None All-in, 3-month average $169/mo All-in from month 4 $169/mo How we got it Medicine $169/mo = $169/mo Basis Listed Sources stallion.com/catalog-product/glp-1-medicati…stallion.com/faqs Read Oct. 28, 2026 Pricing varies by offer; this is our calculation from the seller's public page.
FrontCareSemaglutideCompoundedProvider review, medication, syringes/supplies, 2-day shipping	All-in $229 , highest third	Oct. 28
Medicine, listed $229/mo Membership, listed None Intro or offer None Membership per month None All-in, 3-month average $229/mo All-in from month 4 $229/mo How we got it Medicine $229/mo (normalized from seller billing cadence) = $229/mo Basis Derived Sources frontcare.com/semaglutide frontcare.com/faq Read Oct. 28, 2026 Pricing varies by offer; this is our calculation from the seller's public page.

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Wire

Cuvo Health charges med spas $25 per completed telehealth consult under the spa's brand, with no revenue share.
Dates we're watching: APC meets OIRA on the peptide plan today at 2 p.m. CSPI follows at 2:30 p.m. Faegre Drinker for CEBM and Carmen Group for Medivant meet Wednesday, Oct. 28. ONC's software rule publishes the same day. Lilly reports third-quarter results Thursday, Oct. 29. DEA's telemedicine flexibilities end Dec. 31 unless DEA extends or replaces them. The Hims motion hearing in the FTC case is Jan. 7. OIRA's 90-day review mark falls around Jan. 12.

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Optimized Daily Report is business news for clinic operators. Not medical, legal, or investment advice. Company claims are the company's.