As we know, there is a demand in the market for anti-obesity drugs Wegovy (Navo Nordisk) and Zepbound (Eli Lilly). There are several other versions of such drugs in the market, not necessarily the generics of these two. There are promotional messages on a continuous basis for Wegovy (semiglutide) and Zepbound (tirazepatide). There are anti-diabetic counterparts of these — Ozempic and Mounjaro. There is wide-spread media coverage and outdoor advertising.

Several websites sell these drugs — some 1100 websites mentioned semaglutide. Many illegal online pharmacies sell these drugs. Here these could be obtained without a prescription. These could be counterfeit drugs — contaminated and with varying proportions of semiglutide. The big issue is the uncertainty of the quality of these drugs. Pharmacies can take advantage of a regulatory grey zone which allows them to sell alternative version of a branded drug during a drug shortage. There is doubtful sourcing of the active ingredient in the products of these pharmacies. And in case of infections, whether these pharmacies maintain the sterile manufacturing process.

Some offer fancy dosage forms such as gummies, lozenges and oral drops. The additives, they claim, purport to improve weight loss or minimize side effects. However, they could affect a drug’s efficacy.

Demand outstrips the supply. There may not be insurance coverage. That pushes the customers to buy the cheaper alternatives. There is confusion between genuine pharmacy products, compounded products and counterfeit stuff.

The WHO warned about vials of anti-obesity medicines that contain undeclared ingredients, including insulin. There are dosing errors on account of compounding of medicines. Many end up in hospitals. Novo Nordisk sells single use pens, whereas vials of semiglutide sold by some pharmacists are prone to overdosing on the part of patients. There is a rise in the cases of overdosing and poisoning.

There should be sufficient supply of these medications by approved pharmacies such as Novo Nordisk and Eli Lilly. That will abate the problem. The end of shortage will end the free-for-all compounding. Consumers should know that fake drugs are no bargain.