Experts have grown increasingly concerned about fake versions of Ozempic and popular weight loss drugs. These copycats can look deceptively real, and may contain dangerous substances or entirely different drugs altogether.
In June, the World Health Organization warned that fake batches of Ozempic were found in the United States, the United Kingdom and Brazil. Also in June, Eli Lilly issued a letter expressing concern that counterfeit versions of its own drugs, Mounjaro and Zepbound, were being sold online, through social media and at medical spas.
Those who study the counterfeit drug market say these findings are alarming, but not all that surprising. The drugs are expensive, often hard to find and highly sought-after.
“Such high demand and short supply and such a desperate population — that’s a recipe for disaster,” said George Karavetsos, a former director of the Food and Drug Administration’s Office of Criminal Investigations.
As a result, a counterfeit market has emerged, with phony drugs sold online at low prices without a prescription or any contact with a doctor. Some websites have storefronts to sell what they claim is semaglutide, the substance in Ozempic, which customers can add straight into an online shopping cart. The National Association of Boards of Pharmacy said it had identified thousands of websites illegally selling drugs like Ozempic, including fake versions. Patients often have no way to verify what’s in these products.
Shabbir Imber Safdar, the executive director of the Partnership for Safe Medicines, said he worried about both the rise of fake drugs and also the popularity of compounded semaglutide and tirzepatide, the substance in Mounjaro. These customized versions of drugs are made at compounding pharmacies and under best practices, contain ingredients that come from facilities registered with the F.D.A. But regulators have warned about adverse events linked to compounded semaglutide, and stressed that compounded medications are subject to less oversight than traditionally approved medications.
Counterfeit drugs, on the other hand, are often sold from unregulated and unlicensed online vendors. There is little data on the prevalence of counterfeit Ozempic, but doctors and researchers have said they are highly concerned about the risks to patients.
That’s because products masquerading as Ozempic may contain impure semaglutide, dangerously high doses or other drugs, said Timothy Mackey, a professor at the University of California, San Diego, who studies counterfeit medications. Often, online vendors will pass off research-grade chemicals — which are not safe for humans — as semaglutide meant for consumers, he said.
Criminals also commonly paste fraudulent Ozempic labels onto insulin pens, said Mr. Safdar. After fake Ozempic in Austria landed people in the hospital last fall, health officials said they suspected it was actually insulin. Reuters reported in January that three people in the United States developed hypoglycemia, or dangerously low blood sugar, after taking suspected counterfeit Ozempic.
In the course of researching counterfeit Ozempic, Dr. Mackey and his colleagues tried to buy fake products from online sources. Some orders never showed up, and some vendors claimed they needed an extra thousand dollars to get the drug through customs.
“It’s getting kind of crazy out there,” he said.
What to watch out for
Any counterfeit medication can be dangerous, but fake Ozempic poses a particularly high risk because it is injected. It’s extremely tricky to manufacture sterile injectable drugs, Mr. Safdar said.
One of the biggest risks, he said, comes from consumers being willing to buy these drugs online, without supervision from a doctor.
Dr. Melanie Jay, the director of N.Y.U. Langone’s Comprehensive Program on Obesity, stressed that people seeking out drugs like Ozempic should always see a licensed medical provider for comprehensive care. Doctors need to frequently check in with patients taking these medications to monitor their progress and manage potentially serious side effects, she said.
It is possible for fake Ozempic to end up in traditional health care settings. In June 2023, Ozempic maker Novo Nordisk said that a counterfeit pen purchased at a U.S. pharmacy actually contained insulin. And in December, the F.D.A. said it had seized thousands of units of fraudulent products in the legitimate drug supply chain.
But it is rare for a counterfeit drug to make it that far undetected, Mr. Safdar said. It’s much more likely for people to unknowingly take fake Ozempic if they’re seeking the drug from an unlicensed online vendor or a medical spa, he said. Consumers should also watch out for products sold at a cash price far below the list price of drugs like Ozempic.
Counterfeit medications can have subtle irregularities, like spelling mistakes on the carton, so you should always examine a drug’s packaging.Falsified products may also have flimsy labels that do not stick well to the pen, the W.H.O. said.
Novo Nordisk has resources online for people to ensure their drugs are authentic, and Eli Lilly has tools to help people identify genuine products.
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