Consumers trying to buy popular drugs for weight loss online without a prescription risk being scammed or receiving unsafe products, a new study shows.
About 42% of online pharmacies that sell semaglutide, the active ingredient in Novo Nordisk’s anti-obesity drug Wegovy, are illegal, operate without a valid license and sell medication without a prescription, according to a study published Friday in JAMA Network Open.
People who shop online for weight loss drugs “face serious consumer risks” of receiving “ineffective and dangerous products,” said Tim Mackey, an author of the report and professor of global health at the University of California, San Diego, and also of the. director of the Global Health Policy and Data Institute. The study also includes researchers from the University of Pecs in Hungary.
Lack of popular weight loss medications, which belong to a class of drugs called GLP-1s, have led to “a black market of illegal knockoffs,” said Dr. Christopher McGowan, the founder, medical director and director of research at True You Weight Loss, a weight loss clinic of weight in Cary. , North Carolina.
“This is absolutely terrifying,” said McGowan, who was not involved in the research. Illegal pharmacies “expose patients to risks related to unregulated, low-quality, potentially contaminated products. The average person cannot be expected to safely navigate this minefield of online medications, so it is best to adhere to brand-name medication, authorized by the FDA,” he said.
The popularity of semaglutide has grown in recent years, with more than 2.5 million prescriptions filled in the United States by December 2023, according to a separate study published Friday in JAMA Health Forum.
Manufacturers can’t keep up with demand for the drugs, which can cost up to $1,300 a month out of pocket, and many who can’t find the drugs in their local pharmacies are turning to online and telehealth vendors.
Many buy semaglutide online, which is also sold as Ozempic to treat type 2 diabetes, because their insurance plans won’t pay for the injections or because their doctors won’t write them a prescription, Mackey said. said
Medicare does not cover drugs when prescribed for weight loss, and many state Medicaid plans severely limit coverage. Most people who receive GLP-1 prescriptions have private insurance, according to the JAMA Health Forum study.
“It’s no shock that people are turning to the Internet for alternatives,” McGowan said. “Unfortunately, this is where unscrupulous providers prey on the desperate.”
Illegal pharmacies pose safety risks
In Mackey’s study, he and his colleagues tested samples of semaglutide ordered from six online pharmacies for quality and safety.
Two of the online pharmacies had received warning letters from the Food and Drug Administration in the last year for the illegal sale of unapproved and misbranded semaglutide.
One vial of semaglutide had high levels of endotoxin, a toxin found in bacterial cells, although the researchers found no live bacteria that could cause infection. Being injected with endotoxin, which may have come from environmental pollution during manufacturing, can make people feel sick.
The online purchases shown in the study contained up to 39% more semaglutide than is indicated on the label, which could result in an overdose.
Semaglutide overdose may cause severe nausea and vomiting, as well as dangerous drops in blood sugar, which can lead to fainting, according to the FDA.
From January to November 2023, poison control centers in the United States reported nearly 3,000 calls involving semaglutide, an increase of more than 15 times since 2019. Most overdoses result from dosing errors made by consumers who inject themselves with the drug.
Wegovy and Ozempic, both made by Novo Nordisk, are sold in injection pens that are relatively easy to use. Off-brand versions of semaglutide — which can come from compounding pharmacies or the online pharmacies examined in the study — often come in liquid vials that require consumers to fill a syringe with the correct dose.
On its website, Novo Nordisk says that patients can detect counterfeit medications looking for certain telltale signs, such as packages with spelling errors or that are unsealed, or prices that seem too good to be true.
In a statement, a company spokesperson said patients should be aware that Novo Nordisk is the only drug manufacturer in the United States that produces FDA-approved medicines with semaglutide.
“Telehealth providers and compounding pharmacies that claim to offer or sell unapproved compounded products that claim to contain ‘semaglutide’ source their ingredients from entities other than Novo Nordisk,” the spokesperson said.
online scams
Some websites claiming to be online pharmacies take consumers’ money but never deliver the medications, according to the study.
Although Mackey and the co-authors of the study paid for six orders, they received only three. Three of the websites they ordered from were “no-delivery scams,” asking for additional payments of $650 to $1,200 to help their products “clean up habits,” according to the report.
In the best-case scenario, consumers who buy GLP-1 drugs from illegal online pharmacies “just lose their money,” said Shabbir Safdar, executive director of the Partnership for Safe Medicines, which investigates the dangers of counterfeit medicines. “In the worst case scenario, you end up with medications that are potentially harmful.”
Some people who cannot find semaglutide in their regular pharmacy have turned to compounding pharmacies, which mix or alter drug ingredients to create medications tailored to the specific needs of patients. Legitimate compounding pharmacies do not dispense medication without a prescriptionsaid Scott Brunner, CEO of the Alliance for Pharmacy Compounding, an industry group.
Compounded drugs can be made and distributed with fewer restrictions when the drug appears on the FDA’s drug shortage list, says the agency; Currently, there are several dosages of Wegovy in short supply. However, the FDA warns that “compound drugs are only to be used for patients whose medical needs cannot be met by an available FDA-approved drug.”
In a statement on its website, Novo Nordisk said it is working to address the shortage. “While we will do our best to support those who want to start taking Wegovy, it is important to recognize that overall demand will continue to exceed supply and that some patients may still have difficulty filling Wegovy prescriptions,” the statement read in depart
Safdar said that buying compounded semaglutide carries risks compared to brand-name versions.
People who have made dosing errors while administering semaglutide from compounding pharmacies have been harmed and even hospitalized after accidentally taking too much, according to an alert. issued last week from the FDA.
Brunner said consumers should only buy compounded medications that are licensed by his state board of pharmacy.
Under the best of circumstances, deciding to take a GLP-1 drug is a complex medical decision and patients need regular monitoring, McGowan, from True You Weight Loss, said. Consumers will not receive this type of care if they buy drugs online without seeing a health care provider.
Even if taken directly, GLP-1 drugs can cause many side effects, including nausea, diarrhea, vomiting, constipation, stomach pain, headache and fatigue, and as a result, many people stop taking it after two years. The FDA advises health care providers to monitor patients carefully for kidney disease, eye disease, depression or suicidal behaviors or thoughts.
Some doctors have also observed that GLP-1 drugs can trigger eating disorders in some patients, and the Collaborative of Eating Disorders Organizations, whose members provide treatment or support for people with eating disorders, recommends that doctors screen people for conditions such as anorexia before prescribing. semaglutide.
“If a pharmacy doesn’t require a prescription, a medical consultation or any knowledge of your health, it’s not legitimate,” McGowan said.
“Now, there are no shortcuts,” he said. “Either you are lucky enough to have insurance coverage for GLP-1 medications, or you are willing and able to pay hundreds, if not thousands, of dollars per month in cash. There is currently no proven and safe solution.”
