American Medical Association calls on HHS to rescind the BPC-157 compounding policy and on states to enforce

The American Medical Association has asked the federal government to withdraw its policy letting pharmacies compound BPC-157 and five other unapproved peptides. The association's House of Delegates also directed it to work with state medical and pharmacy boards to pursue enforcement against the compounding pharmacies, telehealth platforms and online sellers that supply unapproved synthetic peptides.

The AMA announced the policy on November 9, 2026, from its interim meeting in Orlando. It answers the notice the Department of Health and Human Services published on October 30. That notice says the department will not act against licensed pharmacies and physicians compounding BPC-157, TB-500, KPV, MOTS-c, epitalon or semax under stated conditions while FDA decides by rule whether to add them to the 503A bulks list.

The AMA's policy changes no law. It is the position of the American Medical Association, adopted by its House of Delegates. It puts the physicians' association on the opposite side from the Alliance for Pharmacy Compounding, which welcomed the HHS notice on the day it was filed. It also points the AMA at the one place where the HHS policy is weakest: the state boards that license the people it is meant to protect.

What the AMA adopted on peptides

The AMA's account of the meeting lists three directives. The delegates told the association to:

Urgently advocate to the Department of Health and Human Services, FDA and relevant federal regulatory authorities to immediately rescind administrative policies, enforcement discretion directives or policy shifts that ease restrictions on compounding and distributing unapproved, non-FDA-reviewed synthetic peptides including those for weight loss, wellness or anti-aging.

Collaborate with federal agencies, state medical boards and state boards of pharmacy to enforce strict regulatory oversight and pursue swift enforcement actions against compounding pharmacies, direct-to-consumer telehealth platforms, and online dispensaries distributing unapproved synthetic peptide formulations lacking FDA regulatory review.

Educate physicians, healthcare providers and the public regarding the severe safety risks, lack of clinical efficacy, and lack of FDA oversight associated with unapproved synthetic peptide compounds and multipeptide "stacks."

The first directive names the instrument HHS used. The notice of October 30 is an enforcement-discretion policy, and the AMA's text asks for the rescission of enforcement discretion directives in those words. The second reaches past the six peptides to every channel that distributes unapproved synthetic peptides, including online sellers.

Ilse R. Levin, an AMA trustee, gave the association's reasoning in its press release: These substances have not undergone the rigorous testing required of FDA-approved drugs, and expanding access without adequate safeguards and oversight could expose patients to serious, preventable harm.

The pharmacists' case for the HHS peptide policy

The Alliance for Pharmacy Compounding made the opposite argument on October 28, the day the notice was filed. Its chief executive, Scott Brunner, framed the question as one of supply, not of whether the peptides should be used:

We've said all along that the question isn't whether patients are using these peptides. They are. The question is where they're getting them.

In the Alliance's view, compounding by state-licensed pharmacies from appropriately sourced and tested API, offers a more accountable alternative to illicit suppliers, and brings the trade into a system of pharmacy standards and adverse-event reporting. The statement welcomes the notice's sourcing and testing conditions and is precise about their limits: the policy, it says, does not add the peptides to the 503A bulks list or make them approved drugs, Nor does it authorize use of research-grade API.

That is the strongest form of the case, and it shares a premise with the AMA's. Both see the research-labeled market as the problem to be solved. They disagree about the answer: the pharmacists want a regulated channel to draw demand away from it, and the physicians want the channel closed and the rest enforced against.

Why the AMA's peptide policy points at the states

The AMA cannot rescind anything. HHS can, and the notice says it may revisit application of this interim policy (in whole or in part) if, among other things, a safety signal or product quality issue arises. Short of that, the AMA's second directive is the one with practical reach, because the HHS notice binds no state.

State boards license the pharmacists and physicians the policy covers, and several had acted before the AMA did. Between May and August 2026 the medical boards of Alabama and South Carolina and three Mississippi boards told licensees that under no circumstances is it permissible to compound or dispense a research-grade peptide. Ohio's Board of Pharmacy has used peptide products as grounds for suspension orders, according to a law firm's review of its published orders. Louisiana went the other way, with a law that bars its boards from blocking peptide compounding that complies with section 503A. Our piece on the state boards and our piece on Louisiana's law set out the record.

A compounding pharmacy put the gap on the federal record during the comment period: it could satisfy every condition of HHS's interim enforcement policy, including API qualification, analytical testing, and documentation, yet remain exposed to disciplinary action by its state licensing authority. The AMA has now said it will work with the boards that hold that authority.

The AMA and the HHS peptide docket

The AMA's policy came four days before comments on the HHS notice closed on November 13. As of November 15, no comment from the AMA appears among the 115 that HHS has posted, all dated November 3 to 6. Of those, 104 are one form letter asking HHS to widen the policy to thymosin alpha-1, kisspeptin-10 and ipamorelin. Our reading of the posted comments sets out who filed what. Comments filed after November 6 have not yet been posted, so whether the AMA filed is not yet known.

What the AMA's peptide policy means for research-labeled peptides

Nothing changes in law. A peptide sold and bought as a chemical for laboratory research is regulated by its intended use, and FDA's warning letters, not professional associations, are the instrument against sellers whose conduct shows otherwise. Are research peptides legal in the US? sets out the federal position.

The AMA's second directive does name online dispensaries alongside pharmacies and telehealth platforms, and commits the association to pressing for swift enforcement actions through federal agencies and state boards. That adds the voice of the medical profession to the record that FDA's 19 warning letters to research-labeled sellers since 2023 already describe. It does not change the line those letters draw.

What to watch after the AMA's peptide vote

• HHS's answer. Whether a final policy, after the comment period, keeps, narrows or withdraws the enforcement discretion, and whether it says anything about state boards.
• The rest of the docket. Whether the AMA, state boards or other associations filed comments before November 13, once HHS posts them.
• State boards. Whether boards that have not spoken follow Alabama, Mississippi and South Carolina now that the AMA has asked them to.
• FDA rulemaking. Only a final rule adding the six to the 503A bulks list would make compounding them lawful under section 503A rather than tolerated.

Frequently asked questions

What did the AMA decide about peptides?

At its November 2026 interim meeting the AMA adopted policy to urge HHS and FDA to rescind policies that ease restrictions on compounding unapproved synthetic peptides. It also committed to work with state boards on enforcement against compounding pharmacies, telehealth platforms and online sellers, and to educate physicians and the public about the risks.

Does the AMA's vote make BPC-157 compounding illegal?

No. The AMA is a professional association; its policy has no legal effect. The HHS notice of October 30, 2026 remains in place until HHS changes it, and state boards decide what their licensees may do. This is not legal advice.

Who supports the HHS peptide policy?

The Alliance for Pharmacy Compounding welcomed it on October 28, 2026, as a more accountable alternative to illicit supply, and most of the comments HHS has posted support it, many asking for it to be widened.

Did the AMA comment on the HHS docket?

No AMA comment appears among the 115 HHS had posted as of November 15, 2026. Comments filed after November 6 had not yet been posted.

Sources & Further Reading

1. American Medical Association. AMA adopts new policies to protect patients and strengthen public health. Press release, November 9, 2026, ama-assn.org.
2. American Medical Association. Highlights from the 2026 AMA Interim Meeting, ama-assn.org, read November 15, 2026.
3. Alliance for Pharmacy Compounding. Statement from Scott Brunner, CEO, on HHS's interim enforcement discretion policy for six peptides, October 28, 2026, a4pc.org.
4. Department of Health and Human Services. Enforcement Discretion Policy Regarding 503A Compounding Using Certain Peptide Bulk Drug Substances; notice of availability. 91 FR 68526, October 30, 2026, FR Doc. 2026-22192, Docket HHS-OASH-2026-0496.
5. regulations.gov, Docket HHS-OASH-2026-0496: 115 comments posted, read through the regulations.gov API, November 14 and 15, 2026.
6. Alabama Board of Medical Examiners, May 26, 2026; South Carolina Board of Medical Examiners, August 18, 2026; Mississippi Boards of Medical Licensure, Nursing and Pharmacy, August 19, 2026. Notices on research-grade peptides.
7. Louisiana Act 374 of 2026 (Senate Bill 253), La. R.S. 37:23.5.
8. Frier Levitt. Peptides Under the Microscope: Recent FDA and State Enforcement Trends, 2026; review of the Ohio Board of Pharmacy's published orders involving peptide products.

Cosmic Peptides. (2026, November 15). American Medical Association calls on HHS to rescind the BPC-157 compounding policy and on states to enforce. Cosmic Peptides Research Library. Retrieved November 15, 2026, from https://cosmicpeptides.com/research/perspectives/ama-peptide-policy

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