The market for weight loss drugs is entering a golden age — or, as many participants in the healthcare arena see it, a gold rush. The effectiveness of new prescription drugs combined with a demand-based shortage has created a perfect storm that has manufacturers and retailers scrambling to cash in. But if popular health and wellness products of the past offer us any insight, it’s that demand begets both innovation and exploitation. A surging market can create opportunities for retailers but also put them and their consumers at risk of illicit, counterfeit, and dangerous products. The prospect of a gold rush always comes with the danger of fool’s gold.

The Demand for GLP-1s

It’s nearly impossible for some consumer demographics to scroll social media or browse the internet without encountering ads for glucagon-like peptide-1 receptor agonists (GLP-1s), drugs that reduce blood sugar and energy intake by activating the GLP-1 receptor. Initially created to treat type 2 diabetes but increasingly used for weight loss, brands like Ozempic and Mounjaro have flooded the public consciousness (and the online ad space). 

After many brand name GLP-1s were placed on the FDA drug shortage list, specialized pharmacies were granted limited permission to compound semaglutide and other similar peptide-based drugs for patients seeking to use them for weight loss purposes. Large numbers of compounding pharmacies began creating their own versions of GLP-1s, often at a much lower price than the brand names. Compounded versions put these drugs within reach of more consumers, which has helped spur even more demand. Nearly all top telemedicine companies have pivoted to offering semaglutide, a type of GLP-1 drug. 

The Current GLP-1 Market: At a Crossroads

The FDA’s allowance for manufacturers to create compounded versions of GLP-1s lasts only as long as there is scarcity, and the administration has begun to remove the affected GLP-1s from its shortage list. The FDA has announced that the shortage of tirzepatide, the active ingredient in Mounjaro and Zepbound, has been resolved, and shortages of other GLP-1s are also poised to be resolved in the near future. That means millions of patients will soon potentially lose access to cheaper, but less regulated, alternatives to the brand name drugs.

High demand and reduced availability created the perfect environment for bad actors to flood the market with unapproved and potentially unsafe products. As seen during past waves of popular drugs and wellness products, the shortage will likely result in fraud, scams, and illicit sales. The onus is now on e-commerce marketplaces, payment service providers, and advertising platforms to step up and ensure violative, potentially dangerous products don’t infiltrate their ecosystems. 

Looking at Past Drug Booms Provides Valuable Lessons for the Road Ahead

• Viagra: The Boom of the 2010’s
  Viagra’s growth during the 2010s was fueled by social and mainstream media attention, leading to heightened demand. With increased demand came an increase in fraud, especially in the form of counterfeit drugs. In 2011, a Pfizer study found that 80% of Viagra online purchases were counterfeit. Consumers seeking affordable alternatives found themselves purchasing dangerous, unverified medications, usually sold without the required prescription. This created a public health risk while also damaging trust in legitimate online pharmacies.

• CBD: The 2018 Farm Bill and Its Aftermath
  The passage of the 2018 Farm Bill, which legalized certain forms of hemp-derived CBD, triggered a surge of untested, low-quality, or falsely advertised products being sold to consumers. A study immediately following legalization found that 67% of tested CBD products had massive potency deviations; 7% of tested CBD products contained harmful heavy metals or solvents; and 98% of surveyed CBD merchants were operating out of compliance. Since then, the FDA has released nearly 20 statements on activities relating to problematic online CBD sales, citing potency deviations, compliance failures, and misbranding as common violations. Without comprehensive oversight, many CBD products made misleading health claims, and bad actors took advantage of the regulatory ambiguity to push harmful products. The result was consumer confusion, increased scrutiny from regulatory bodies, and reputational harm to platforms that allowed these products to thrive.

• Pandemic-Related Drugs
  During the height of the COVID-19 pandemic, chloroquine and hydroxychloroquine became household names because of unverified claims of their effectiveness in treating the virus. This led to a spike in demand, with online platforms overwhelmed by problematic sellers taking advantage of vulnerable consumers by offering unapproved versions of these drugs sold for improper purposes. 

What to Watch Out for With GLP-1s

Once the FDA’s compounding allowance for GLP-1s ends, here’s what to expect:

• Illicit compounding: While legitimate compounders and telemedicine companies will stop creating the duplicates of the drugs, problematic compounding, may continue to create “generic” versions to sell to US customers. These are unapproved for use in the US and may be subject to other quality and compliance concerns. 
• Counterfeits: Some bad actors, often located overseas, may sell counterfeit or unapproved versions of popular brand names, possibly replicating the packaging that may contain illicit versions of the drug or something else entirely.  For example, counterfeit weight loss drugs, including Ozempic, sold to customers through unofficial channels were misbranded and some contained harmful bacteria that resulted in lesions.
• Scams: Some bad actors may set up websites and product listings to sell brand name GLP-1 drugs at a discount, but in actuality they will not ship anything to customers (called a nondelivery scheme).
• Problematic claims: Sellers of other products, like yellow oleander supplements, will make misleading claims that their products are “natural alternatives” to prescription drugs and that they can treat obesity and diabetes. Supplements and other non-drug products cannot claim to treat, prevent, or mitigate diseases.

The Need for Monitoring and Certification

Past popularity surges in drugs and other wellness products offer a cautionary tale: as demand rises, so does the potential for dangerous, unregulated products to infiltrate the market. In the case of GLP-1 drugs, marketplaces, payment service providers, and e-commerce platforms must take proactive steps to prevent history from repeating itself.

Robust monitoring of sellers and products is one of the most effective ways to mitigate this risk. Advanced technologies, such as AI-powered data analysis, are balanced with expert analysts to help businesses track trends in real time, identify high-risk merchants, and remove potential violations before they escalate. This level of oversight is essential in ensuring that harmful merchants, ads, and product listings are swiftly removed from platforms, protecting consumers and the reputation of legitimate businesses.

Certification is another crucial piece of the puzzle. It provides a clear, verifiable signal that merchants operating in highly regulated industries adhere to the strict, often evolving regulatory guidelines and comply with jurisdictional requirements. When online pharmacies, telehealth providers, and other healthcare merchants get certified, they can build trust with consumers, work more easily with third parties such as payments companies, and take advantage of advertising opportunities on major online platforms. 

Keeping Consumers Safe

Finally, it’s important to consider the patient’s perspective. With so many unverified products circulating, consumers must be vigilant when purchasing medications online. They should look for certified sellers, avoid deals that seem too good to be true, and always verify the legitimacy of the products they buy.

The surge in demand for these medications has created fertile ground for unscrupulous advertisers and merchants to introduce unsafe and counterfeit products. Rigorous monitoring of platforms and payment portfolios, merchant certification, and consumer education will protect patients, safeguard the market’s integrity, and avoid the pitfalls seen in previous product booms. It’s time to prioritize consumer safety and ensure that the GLP-1 market remains a reliable and trustworthy source of essential healthcare.

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