A recent study reveals that consumers who attempt to purchase popular weight loss medications online without a prescription run the danger of being duped or obtaining faulty goods.
A study published in JAMA Network Open on Friday found that approximately 42% of online pharmacies offering semaglutide, the active ingredient in Novo Nordisk’s anti-obesity medication Wegovy, are operating illegally, without a valid license, and selling pharmaceuticals without a prescription.
Online buyers of diet pills “face serious consumer risks” of getting “ineffective and dangerous products,” according to Tim Mackey, director of the Global Health Policy and Data Institute and professor of global health at the University of California, San Diego, who also wrote the report. Researchers from Hungary’s University of Pecs were also involved in the investigation.
A “black market of illegal knockoffs” has emerged due to shortages of the well-known weight-loss drug, which is part of the GLP-1 drug class. This was stated by Dr. Christopher McGowan, the founder, medical director, and research director of True You Weight Loss, a weight-loss clinic located in Cary, North Carolina.
According to McGowan, who was not engaged in the research, “this is absolutely terrifying.” Patients are “exposed to dangers posed by unregulated, subpar, and perhaps tainted goods” by illegal pharmacies. It’s preferable to stick to name-brand, FDA-approved prescriptions since it’s not realistic to expect the average individual to properly traverse this internet medication maze,” he said.
A other study that was published on Friday in JAMA Health Forum claims that semaglutide’s popularity has increased recently and that by December 2023, over 2.5 million prescriptions will be filled in the United States.
prescriptions can cost up to $1,300 per month out of pocket, and manufacturers are unable to keep up with demand. As a result, many people who can’t get the prescriptions in their neighborhood pharmacy turn to telehealth and internet sellers.
According to Mackey, a lot of people purchase semaglutide, also known as Ozempic, online to treat Type 2 diabetes because their insurance companies won’t cover the injections or because their doctors won’t write a prescription for them.
When prescribed for weight loss, Medicare does not cover the medications, and many state Medicaid programs severely limit coverage. The majority of patients prescribed GLP-1 have private insurance, per the JAMA Health Forum research.
McGowan remarked, “It is not shocking that people would look for alternatives online.” Sadly, this is the area where dishonest vendors take advantage of the weak.
Risks to safety arise from illegal pharmacies
In order to ensure the quality and safety of the semaglutide samples they received from six internet pharmacies, Mackey and his colleagues conducted tests.
The Food and Drug Administration had issued warning letters to two of the online pharmacies in the past year for selling semaglutide that was not authorized or that was mislabeled.
Researchers did not identify any live bacteria that may cause infection, but one vial of semaglutide contained high quantities of endotoxin, a toxin found in bacterial cells. People can become ill after receiving an injection of endotoxin, which may have originated from environmental contamination during manufacture.
An overdose could occur from the up to 39% more semaglutide in the study’s sampled internet purchases than what was stated on the label.
According to the FDA, taking too much semaglutide can result in significant blood sugar reductions that can cause fainting, as well as extreme nausea and vomiting.
Control poison centers nationwide reported receiving about 3,000 calls involving semaglutide between January and November 2023—a more than 15-fold increase from 2019. The majority of overdoses were caused by drug users who injected themselves with incorrect dosages.
Both Novo Nordisk products, Wegovy and Ozempic, are available in injection pens that are rather simple to use. Off-brand forms of semaglutide, which are available from compounding pharmacies and the internet pharmacies the study looked at, frequently come in liquid vials that need to be filled with the appropriate dosage using a syringe.
Novo Nordisk claims on its website that patients can identify fake drugs by looking for specific indicators, like packages that are unsealed or have spelling mistakes, or prices that appear too good to be true.
A representative for the business said in a statement that Novo Nordisk is the only American pharmaceutical company that produces FDA-approved semaglutide-containing medications.
“Compounding pharmacies and telehealth providers who assert to sell or offer unapproved compounded medications purporting to contain semaglutide are sources of components other than Novo Nordisk,'” the spokeswoman stated.
Scams online
The survey found that some websites posing as online pharmacies collect money from customers but never actually send the prescriptions.
Mackey and the other study authors paid for six orders, but they only got three in return. According to the investigation, three of the websites they ordered from were “non-delivery scams,” requesting extra payments ranging from $650 to $1,200 in order to facilitate the products’ “clearance customs.”
Purchasing GLP-1 medications from unlicensed online pharmacies might result in customers “just losing their money,” according to Shabbir Safdar, executive director of the Partnership for Safe Medicines, an organization that investigates the risks associated with fake medications. “In the worst case, you wind up taking potentially hazardous medications.”
Compounding pharmacies, which combine or modify drug ingredients to make drugs catered to particular patient needs, have become the go-to option for certain individuals who are unable to get semaglutide at their usual pharmacy. According to industry group Alliance for Pharmacy Compounding CEO Scott Brunner, legitimate compounding pharmacies never give drugs without a prescription.
When a medication is listed on the FDA’s list of medications in shortage, fewer limitations apply to its manufacture and distribution. At the moment, there is a scarcity of several dosages of Wegovy. Nevertheless, the FDA issues a warning, saying that “Compound pharmaceuticals should only be used by patients whose medical demands cannot be satisfied by currently available FDA-approved medications.”
Novo Nordisk stated on its website that it is addressing shortages. Part of the statement says, “Wegovy will continue to be in higher demand than supply overall, and some patients may still have trouble filling their prescriptions, despite our best efforts to support individuals who wish to begin taking the medication.”
According to Safdar, purchasing compounded semaglutide entails greater danger than purchasing name-brand equivalents.
In a notice sent last week, the FDA stated that people who mishandled doses of semaglutide from compounding pharmacies had suffered consequences, including being hospitalized.
According to Brunner, patients should only purchase drugs from compounders who hold a state board of pharmacy license.
According to McGowan of True You Weight Loss, choosing to take a GLP-1 medication is, in the best of cases, a complicated medical choice that requires ongoing patient monitoring. If customers purchase medications online without first visiting a doctor, they won’t receive that level of care.
Many patients discontinue taking GLP-1 medicines after two years because they can induce a variety of adverse effects, even when taken as prescribed. These consequences include nausea, vomiting, diarrhea, constipation, stomach discomfort, headaches, and exhaustion. Healthcare professionals are advised by the FDA to closely monitor patients for signs of depression, kidney illness, eye disease, and suicidal thoughts or behaviors.
Additionally, some physicians have noticed that GLP-1 medications can cause eating disorders in certain patients. The Collaborative of Eating Disorders Organizations, whose members treat or support individuals with disordered eating, advises physicians to check patients for anorexia before prescribing semaglutide.
McGowan declared, “A pharmacy is not legitimate if it doesn’t require a prescription, a medical consultation, or any understanding of your health.”
He declared, “At this time, there are no short cuts.” “You have two options: either you’re lucky enough to have insurance that covers GLP-1 medications, or you have the means to pay hundreds or even thousands of dollars in cash each month. There isn’t presently a tried-and-true, secure solution.