This year is a dynamic and fast-paced one for compounding pharmacy M&A. Early in the year, unpredictability in the broader economy created challenges for transactions and Semaglutide created a boom for sellers. but pause for buyers. However, as the year progressed, anxiety dissipated, and buyers resumed their acquisition mandates. Last but not least, the constant pressure of changing regulatory standards continued to bring owners to the marketplace seeking exits and partnerships. Altogether, 2023 will go down as one of the busiest M&A years in recent history for compounding pharmacy. This article covers three major influences on M&A activity in compounding pharmacy throughout the year and discusses their long-term impacts on the industry: USP 800, Semaglutide, and Competitive Forces.