Online Pharmacies Are Illegally Selling GLP-1s Without Prescriptions
A study found that test products purchased from illegal online pharmacy operations had lower purity levels and significantly more semaglutide content than what was advertised on the label.
Illegal online pharmacies have been found to be selling unregistered and falsified semaglutide products without prescription, according to recent data published in JAMA Network Open.1 The authors of the study said that the findings support the need for increased pharmacovigilance, particularly for online sources.
Online Pharmacies Are Illegally Selling GLP-1s Without Prescriptions / Fernanda - stock.adobe.com
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1), a class of medications that are approved to help manage type 2 diabetes. GLP-1s have also been shown to help prevent cardiovascular disease, improve weight loss, decrease progression of chronic kidney disease, and may even have neuroprotective effects in patients with Alzheimer’s disease.2,3
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Over the past several years, the use of GLP-1s has increased significantly. Data shows that GLP-1 use increased 40-fold between 2017 and 2021, with about 6 million people in the United States taking semaglutide (Ozempic) or tirzepatide (Mounjaro).4 The rise in awareness of semaglutide’s weight-loss benefits, which began around late 2022, further drove the demand for GLP-1s.5 This has resulted in shortages of the drugs and a proliferation of dangerous products being sold on the illegal market.
“We’ve seen people hurt by illegal online pharmacies for almost as long as the Internet has been around,” Shabbir Safdar, executive director of the Partnership for Safe Medicines, said in a release.6 “Fake drugs to treat cancer, HIV and diabetes have all been linked to online pharmacies. The difference now is the unprecedented popularity of the new diabetes and weight-loss injectables. Inevitably, bad actors see this scenario and look to profit.”
A team of investigators from the University of Pécs in Hungary and the University of California San Diego conducted a qualitative study to determine the risk of semaglutide online sourcing. For the study, a search was done on Google and Bing to find websites that were advertising the sale of semaglutide without a prescription in July 2023. Researchers than purchased 2 0.25 mg prefilled injection vials of semaglutide or equivalent from websites that met inclusion criteria, which underwent visual and quality inspections to determine falsification risks, sterility, and microbiological contamination.
Over 1000 websites were generated during the search, with 317 being online pharmacies. Of those, 134 were illegal pharmacy operations and 6 were chosen for test buys. Of the illegal pharmacies chosen for test buys, 3 offered prefilled 0.25 mg per dose semaglutide injection pens, and 3 sold vials of lyophilized semaglutide to be reconstituted to solution for injection. However, only 3 products were actually received—the other 3 were nondelivery scams that requested additional payment. Prices for the products ranged from $113 to $360.
Investigators found that compared to genuine Ozempic samples, which scored 22 points on the International Pharmaceutical Federation’s checklist, the purchased test products’ scores ranged from 8 to 9. These products also had discrepancies in regulatory registration information and had evidence that they were likely unregistered or unlicensed.
Additionally, 1 of the test products had elevated levels of endotoxin, and while most had semaglutide in them, they had considerably lower purity levels. The semaglutide content in the test products also had significantly more than what was advertised on the labels, with some samples exceeding by 29% to 39%.
“This qualitative study found that semaglutide products are actively being sold without prescription by illegal online pharmacies, with vendors shipping unregistered and falsified products,” the authors concluded. “US poison centers have reported a 1500% increase in calls related to semaglutide, highlighting the need for enhanced pharmacovigilance including for online sourcing harms.”
READ MORE: Public Health Resource Center
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