Legit Ozempic sales soar while counterfeits put patients in danger

Two new studies show how eager Americans are to obtain either safe, legitimate versions of Ozempic or counterfeit and potentially dangerous forms of the diabetes/weight-loss drug.

One study found U.S. prescriptions and refills of Ozempic (semaglutide) soaring over the past three years, jumping almost five-fold (392%) between early 2021 and the end of 2023.

Ozempic's reformulated-for-weight-loss cousin, Wegovy (also semaglutide), saw sales soar soon after its launch as well.

According to researchers led by Dr. Dima Qato, an associate professor of clinical pharmacy at the University of Southern California, sales of Wegovy climbed more than 14-fold between July 2021 and the end of 2023.

"The number of prescriptions filled for semaglutide has increased substantially, reaching 2.6 million prescriptions filled at retail pharmacies by December 2023," Qatos's team reported Aug. 2 in the journal JAMA Health Forum.

It's all led to U.S. shortages of both Ozempic and Wegovy, first announced by the U.S. Food and Drug Administration in March of 2022, the researchers noted.

Consumers who either can't find semaglutide because of shortages, or who cannot afford the drugs (Wegovy is about $1,349 per month), are increasingly turning to black market vendors online, a second study found.

That's a dicey move, warned researchers at the University of California, San Diego (UCSD).

They found many online counterfeit semaglutide products either contaminated with toxins or containing hazardous doses of the drug. In some cases, the drugs simply weren't delivered after consumers sent vendors hundreds of dollars.

A team led by Tim Mackey, of UCSD's Global Health Program, conducted online searches that turned up 317 online pharmacies offering semaglutide, 134 of which were found to be illegal operations.

MacKey's groups ordered semaglutide from six sites already declared "not recommended or rogue" by two leading online pharmacy watchdog groups.

Three sites were offering consumers the standard 0.25 milligram semaglutide injection pens (similar to Wegovy), while the other three offered a powdered form of the drug that could be "reconstituted for injection," the researchers said.

The drugs weren't cheap, with the smallest doses ranging from $113 to $360.

Consumers typically didn't get what they had hoped for.

In the case of three of the vendors, the product simply never arrived, in what Mackey's team called "nondelivery scams." In these scams, vendors take your money but then claim that the drug is being held at U.S. Customs and further payments up to $1,200 are needed to release them (U.S. Customs told Mackey's team that such claims are fraudulent).

However, potentially worse outcomes may await people who do receive their orders.

Genuine, branded Ozempic scores 22 out of 22 points on a checklist aimed at assessing drug purity and safety. Unfortunately, products from the remaining three vendors that were received and then tested by researchers could only muster a pathetic 8 or 9 at best on the scale.

These products typically had shoddy labeling and were clearly unlicensed for sale, the UCSD team said.

Beyond that, one sample showed traces of endotoxins (a potential signal for bacteria), although no specific pathogen was detected.

All of the products contained some semaglutide, "but with considerably lower purity levels," Mackey's team wrote. One sample contained 39% higher amounts of semaglutide than is recommended, a potentially dangerous issue.

All of this could be contributing to illnesses and overdoses, the researchers noted.

"U.S. poison centers have reported a 1500% increase in calls related to semaglutide," Mackey and colleagues noted.

These illicit online pharmacies "operate without valid licenses and sell medicines like semaglutide without prescription, [and] represent a consumer risk for ineffective and dangerous products," the team concluded.

The study was published Aug. 2 in the journal JAMA Network Open.

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