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January 18, 2023

Patients who can't get weight-loss drugs are turning to risky sources

Daily Briefing

    Weight-loss drugs like semaglutide and tirzepatide are in short supply, leading many consumers to purchase the compounds for the drugs from risky and unregulated sources, Elaine Chen reports for STAT.

    Weight-loss drug shortages lead patients to other sources

    Semaglutide—sold by Novo Nordisk under the brand name Ozempic for diabetes and Wegovy for obesity—and tirzepatide, made by Eli Lilly under the brand name Mounjaro as a diabetes treatment, are part of a class of medications known as GLP-1 drugs.

    These drugs mimic a hormone called glucagon-like peptide-1 to target areas of the brain that regulate appetite and food intake. In 2021, FDA approved Wegovy for the treatment of obesity after a clinical trial showed it helped patients lose an average of 15% of their body weight over 68 weeks. Mounjaro has also been approved by FDA, but only to treat Type 2 diabetes.

    However, many patients have found it difficult to access these drugs, in part because of months-long supply shortages.

    As a result, many consumers have been turning to websites that list semaglutide and tirzepatide as chemicals they sell, Chen reports. And while they are intended only for lab research purchases and not for human use, many of the websites market the drugs in a way that appeals to individuals.

    For example, the website Extreme Peptide says people can earn rewards on their orders for future purchases, SAF-Research's website offers a buy now, pay later option, Chen reports.

    Consumers have also been turning to compounding pharmacies, which mix the active ingredients of drugs with other chemicals to provide ready-made compounds, Chen reports.

    In a statement, Novo said it does not provide or sell bulk semaglutide, and that alternative compounded products "do not have the same safety, quality, and effectiveness assurances as FDA-approved drugs and may expose patients to potentially serious health risks."

    Eli Lilly in a statement said that Mounjaro "is only available in a pre-filled single-dose pen manufactured by Lilly. Mounjaro is not commercially available in any other form."

    Why these sources can be risky

    Experts say acquiring these weight-loss drugs through alternate routes can be risky, since neither Novo nor Eli Lilly sell their drugs to other manufacturers. Therefore, it's not clear what's inside the alternative products, and the drugs are not regulated in the same way traditional medications are.

    According to Jamie Almandoz, medical director of the University of Texas Southwestern Weight Wellness Program, ordering from peptide suppliers could be dangerous because it's not clear what's inside the chemicals and people could be mixing them incorrectly or in a non-sterile environment, which could cause an infection.

    Compounding pharmacies could prove less risky since professionals are supposed to be mixing the drugs in a sterile environment, Almandoz added, but it's also not clear where those pharmacies are getting their active ingredients, and there's no safety or effectiveness data on the compounded products.

    Almandoz said he understands patients' desire to obtain these drugs, but whenever his patients ask about compounding pharmacies, "I get very anxious and I try to counsel them away" from that option, adding that there are other drugs and procedures like bariatric surgery that could be considered.

    The excitement surrounding these drugs, also referred to as the "Hollywood drug," could be leading people to gravitate towards them more immediately, "skipping from A to Z," said Jamy Ard, co-director of the Atrium Health Wake Forest Baptist Weight Management Center. "There are some people who definitely need an incretin treatment strategy, but it is not the only thing, it is not the absolute solution for everyone."

    "It just shows you the level of desperation that people have and the level of unmet need that we have when it comes to treating obesity effectively," Ard said.

    Ultimately, "people are desperate to have better health," Almandoz said. "The fact that people are resorting to nontraditional pathways to get medications which may be risky speaks to their desire for better health." (Chen, STAT, 1/18)

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