Since the FDA approved prescription GLP-1 drugs for weight loss, it has become difficult to get the original product.
Demand for semaglutide, a GLP-1 sold under the brand names Ozempic and Wegovy, is so high that it became almost immediately in short supply after its approval for weight management in 2021.
And even if you can afford it, a month’s supply costs over $1,000.
Of course, this has spawned a wave of cheaper copycat drugs.
Researchers watched nervously as the resulting gray market for so-called generic semaglutide exploded. Pharmacies are Under certain circumstances and with a prescription, they are technically allowed to make their own versions of brand-name drugs, but some websites offer the drugs without a prescription, no questions asked.
It raises the question: What is included in the online versions of semaglutide and how can consumers know what they are getting and whether it is safe?
Enter Timothy Mackey, a professor at the University of California, San Diego, who has been studying the online market for counterfeit drugs for decades. He decided to buy some of these cheaper, more readily available weight-loss drugs himself and test them in a lab with a team of researchers.
Their findings, published August 2 in JAMA Network Open, provide some of the clearest information yet about what is – and isn’t – included in the copycat versions of Ozempic.
Some websites have cheated people out of their money
Not all no-name products of semaglutide are illegal or necessarily dangerous. Popular telemedicine companies typically make it easy for their customers to obtain a prescription through an online consultation and offer compounded semaglutide that is cheaper than the brand-name versions.
This process comes with risks, Mackey said. There is less oversight than an in-person doctor’s visit, and compounded drugs are not FDA-approved and can contain unpredictable additives. However, the pharmacies that fill these prescriptions are regulated and have some level of quality control.
Mackey’s team was particularly interested in what they believed to be the riskiest form of semaglutide – weight-loss drugs sold online without a prescription. They collected samples of these products to test.
All of the websites the researchers used to purchase and test the products appeared in the top results of major search engines and had millions of visitors, according to an analysis of site traffic, Mackey told Business Insider.
They found that half of the websites advertised the branded product Ozempic, which cost between $190 and $360 for two pens plus delivery fees. Ozempic was in short supply when they conducted the study, and even doctors struggled to get the real drug through official channels. Predictably, the branded products never arrived. When the researchers inquired, they were asked to pay extra money. — between $650 and $1,200 – to “pass customs,” but it was a scam, as researchers discovered after contacting customs authorities.
Dangerous ingredients and concentrations
The other websites advertised generic semaglutide. They did indeed supply the product, but in dubious form and with inconsistent dosages.
For one thing, all of the samples came in powder form, so users had to dissolve the powder with special sterilized water before injecting it. (This practice is common in online sales of peptides, a popular category of fitness and anti-aging supplements.) Only one of the products provided instructions on how to do it. If you do it wrong, there’s a serious risk of contamination, Mackey said.
All samples were advertised as 99% pure semaglutide. However, testing showed that the purity was between 7% and 14%. The samples also contained higher doses of semaglutide than indicated on the label – up to 39% more per batch – increasing the risk of overdose. According to the FDA, too much semaglutide can cause serious gastrointestinal side effects such as vomiting, as well as dehydration and acute pancreatitis.
Mackey’s team also found that the products were likely research-grade semaglutide, which was never intended for human use. The websites used creative marketing language and imagery to suggest that their products were intended for humans without saying so outright.
One of the products also contained high levels of endotoxin, a harmful substance found in bacterial cells (although no live bacteria were observed).
According to CNN, poison control centers recorded a massive increase in semaglutide overdoses last year. Given his team’s findings, Mackey is not surprised. “This is a clear sign that the product is not intended for human use,” Mackey said. “The bottom line is that there are inconsistencies in the manufacturing process.”
Fake Ozempic won’t go away, so beware, buyers
Mackey said a wave of telemedicine services and online providers has made it easier than ever to get prescriptions and medications online. But it’s also harder to spot a scam now than when everything had to be ordered from a pharmacy after an in-person consultation with a doctor.
“The average user is rather confused about how to get this legally,” he said.
Illegal websites can be convincing, but if they claim that their weight loss drugs don’t require a prescription, Mackey says that’s a big red flag.
Another red flag is the cost. The brand-name product semaglutide can cost you more than $1,000 a month. If a product is offered online for significantly less, you are likely getting what you paid for – a low-quality or counterfeit product.
“If vendors advertise $200, it’s because they’re not real. But they’re still advertising a lower price and that’s attractive to consumers,” Mackey said.
Despite the risks and the FDA’s efforts to crack down on scammers and shady products, the weight loss drug market is simply too big, too new, and too chaotic to expect the counterfeits to end anytime soon.
“This is going to ripple through our supply chain because the market is so popular,” Mackey said. “It’s kind of an arms race here.”
