It's still expensive, but far cheaper than brand name with similar efficacy. Competition from these programs will likely drive costs much lower over the next few years.
Semaglutide is still under patent in the US till at least Dec 2031 (say Wpedia).
Blockbuster drugs still under patent usually don't have alternative avenues of supply that are significantly cheaper than the main avenue. I wonder what law or regulation allows this alternative avenue to persist.
They are compounding the useful, active ingredient which they are purchasing from some mass manufacturer with some pointless thing they happen to have on hand and that provides a legal fig leaf that the medicine was tailored specifically for you.
The reason compounding pharmacies are very useful in the US is not because the process of compounding is useful; it's that they have carveouts in regulations that make it hard for the FDA to control them. When there is a drug that is useful and safe, but not approved by the FDA for the purpose you want to use it, you can often get it from a compounding pharmacy.
Semaglutide is a GLP-1 agonist. There are many other GLP-1 agonists, of varying efficacy and side effects, and many of them which a compounding pharmacy can purchase in bulk at very reasonable prices. However, only Semaglutide has been FDA approved for the indication of weight loss, and being the sole approved product means they can milk their patent-granted monopoly for a ridiculous amount of money. Simply because without FDA approval, you cannot get the other similar drugs for the purpose of weight loss. Unless you go to a compounding pharmacy, which, for dumb historical reasons, happen to have loopholes in FDA regulation, so long as they are artisanally producing compounded drugs tailored to a specific individual.
I think you are confused about what a compounding pharmacy is -- at least if you refer to how it works in the US.