When people are desperate to lose weight they often go to great lengths to achieve their goal. That was true over a decade ago when people were hot to buy orlistat (Xenical, Alli). Nowadays, people are excited about GLP-1 agonists containing semaglutide (Ozempic, Wegovy) or dual action GLP-1 and GIP-agonists containing tirzepatide (Mounjaro, Zepbound). These drugs are being heralded as miracles for shedding excess pounds. Few medications have received as much publicity as these products. There’s a lot of money in play and the demand has led to drug shortages. It’s not surprising, then, that counterfeit weight loss products have started cropping up on the web.
Counterfeit Drugs Are Nothing New:
On January 18, 2010, the FDA warned consumers:
“…about a counterfeit and potentially harmful version of Alli 60 mg capsules.”
The FDA went on to warn people about counterfeit Alli that contained sibutramine (Meridia) instead of orlistat:
“Preliminary laboratory tests conducted by GlaxoSmithKline (GSK)—the maker of the FDA approved over-the-counter weight-loss product— revealed that the counterfeit version did not contain orlistat, the active ingredient in its product. Instead, the counterfeit product contained the controlled substance sibutramine. Sibutramine is a drug that should not be used in certain patient populations or without physician oversight. Sibutramine can also interact in a harmful way with other medications the consumer may be taking.”
Over a decade ago we wrote:
“Alli is the only FDA-approved non-prescription weight loss drug. It is a lower dose of orlistat, prescribed under the brand name Xenical. The FDA is now warning consumers about counterfeit Alli. The counterfeit pills, most of which appear to be purchased online, do not contain orlistat. Instead, they contain a controlled substance called Meridia or sibutramine.
Side effects may include headache, insomnia, constipation, dry mouth, increased blood pressure and heart rate. The drug can also interact in a dangerous way with many other medicines. To check on Alli, open a capsule and see if it is filled with tiny white pellets or white powder. The powder is counterfeit and should be reported to the FDA.”
Fast forward 14 years to December 21, 2023:
FDA Warns About Fake Ozempic:
Last December the FDA warned (12/21/2023) “consumers not to use counterfeit Ozempic (semaglutide) found in the U.S. drug supply chain:”
“FDA continues to investigate counterfeit Ozempic (semaglutide) injection 1 milligram (mg) in the legitimate U.S. drug supply chain and has seized thousands of units of the product. The agency advises wholesalers, retail pharmacies, health care practitioners and patients to check the product they have received and not distribute, use, or sell products labeled with lot number NAR0074 and serial number 430834149057 as pictured below. Some counterfeit products may still be available for purchase.”
Here is the FDA’s image of some counterfeit Ozempic. It probably is no longer relevant, though, since so many other players have gotten into this game.
Fast Forward to April 15, 2024:
Our go-to insider publication for all things pharmaceutical is FIERCE Pharma. These folks cover the drug industry with a magnifying glass. On April 15, 2024, we saw this headline from FIERCE Pharma:
“Takedowns of website peddling fake GLP-1 drugs jump as counterfeiters board weight loss bandwagon.”
The introduction to the article states:
“Eli Lilly and Novo Nordisk faced a third rival for the GLP-1 market last year: counterfeiters. BrandShield helped remove more than 250 websites peddling the blockbuster medicines in 2023, the cybersecurity company told Reuters, as the weight loss therapies emerged as a major focus of anticounterfeit activity.”
Counterfeiters have been making fake drugs for years. The Internet has given them access to hundreds of millions of people all over the world.
According to the article from FIERCE Pharma:
BrandShield, backed by the Pharmaceutical Security Institute, helped remove 1,655 website in 2023. These were sites selling problem drugs. That number was dramatically higher than the 434 sites that were removed in 2022.
Another Potential Problem: Counterfeit Botox:
Another drug that is attracting counterfeiters is botulinum toxin, better known as Botox. The CDC reports that people in 9 states have been harmed as a result of counterfeit products or drugs from unverified sources.
On April 16, 2024 the FDA published this headline:
Counterfeit Version of Botox Found in Multiple States
The agency provided this warning:
“FDA is alerting health care professionals and consumers that unsafe counterfeit versions of Botox (botulinum toxin) have been found in multiple states and administered to consumers for cosmetic purposes.
“FDA is aware of adverse events, including hospitalizations, linked to the counterfeit Botox. Symptoms included blurred or double vision, difficulty swallowing, dry mouth, constipation, incontinence, shortness of breath, weakness and difficulty lifting one’s head following injection of these products. These symptoms are similar to those seen when botulinum toxin spreads to other parts of the body.”
Botox is approved “for the temporary improvement in appearance.” In other words, these injections help reduce frown and forehead lines.
Where’s the FDA When It Comes to Counterfeits?
One of the problems with the Food and Drug Administration is that it relies heavily on industry to catch problems. That also applies to generic pharmaceuticals. The agency itself does very little, if any, testing. It’s a token effort at best.
That means that there is no real testing of the American drug supply, whether products are coming from 0nline sources or your local neighborhood pharmacy. We have watched the independent laboratory, Valisure, try to fill the vacuum, but it’s a relatively small operation. It has caught a number of contamination problems. But it cannot test all the online sales outlets, let alone the American pharmacy supply chain.
Final Words:
The latest counterfeit drug scandal reveals how vulnerable people are when it comes to shopping online. If a website is offering to sell you a prescription drug without a prescriber’s involvement, be very suspicious.
If an expensive weight-loss drug like Wegovy is being sold for far less than the market price, resist the temptation to purchase it. The GoodRx.com list price for Wegovy is close to $1,600 for a month’s supply of 4 prefilled pens. Even with a GoodRx.com coupon, the price is still around $1,400. Anything less is likely to be problematic, especially if you do not need a prescription.
Please share your thoughts about counterfeit drugs in the comment section below.
