It was only a matter of time.
Soaring demand for a drug touted by online influencers to help lose weight, but whose supplies in Europe are restricted, has caused a surge in fake and potentially dangerous concoctions of the injection, putting lives at risk.
In the first seven months of this year, Ireland alone has seen a fivefold increase in illegal imports of semaglutide — the active ingredient in diabetes drug Ozempic and weight loss drug Wegovy — compared with the whole of 2022. In France patients are presenting fake prescriptions to try to get the drug, while rogue spas have been selling semaglutide seemingly without the need for a prescription, making it illegal and potentially fake.
Amid severe supply restrictions for Ozempic and Wegovy, patients are turning to social media and online pharmacies in a desperate bid to get their hands on the drugs, which hold the potential to revolutionize the treatment of obesity. In a clinical trial, patients with obesity lost some 15 percent of their body weight over 68 weeks, compared with those on a placebo.
Influencers on TikTok, Facebook and X, formerly Twitter, jumped on the news. It ignited a frenzy of online sellers, offering cheaper counterfeit versions of the drug, re-selling prescribed medication or offering raw ingredients to mix at home.
While some buyers might get their hands on the real drug — possibly a dispensed injection pen re-sold illegally — the majority of semaglutide bought online is likely to be either a counterfeit version from an unlicensed source with all manner of unknown toxicities or, worse, a total fake containing anything from sugar water to deadly heavy metals and rat poison.
Yet Europe’s drugs regulator, which ensures medicines in the bloc are both safe and effective, said it has no responsibility over fake injections being mailed to European citizens from fraudulent online pharmacies and labs.
The European Medicines Agency told POLITICO that “dealing with falsified or counterfeit medicines is a matter for law enforcement and this is outside the scope of EMA’s responsibilities.” When asked if they had received reports of fake semaglutide, they didn’t provide any. Instead, they suggested contacting Europe’s crime agencies — which we did.
A spokesperson at Europol told POLITICO: “We are aware of this phenomenon and currently supporting operational activities targeting the trafficking of such illegal substances. As operational activities are currently ongoing … we are not able to communicate further at this point in time.”
Buying semaglutide online
In Europe, Wegovy and Ozempic are only available on prescription. While Ozempic has been available since 2018 for diabetes, weight loss drug Wegovy has only launched in Denmark, Norway, Germany and the U.K. Outside Europe, it’s available in the U.S.
Demand is so high for the drugs, which people have to take long-term, that their maker, Novo Nordisk, is limiting further launches and countries are restricting prescriptions to the most needy patients.
So people are searching for alternative sources.
Research by POLITICO found numerous online sites in Europe offering “semaglutide” for sale at prices from around €100 to several hundred euros for a week’s supply. One site, based in the U.K., even shows users how to mix two ingredients together to purportedly make the drug.
But the chances of the clear liquid actually being semaglutide are slim. A study by the Alliance for Safe Online Pharmacies (ASOP Global) found that, out of 33 medicines bought online, 62 percent was fake or substandard.
POLITICO contacted multiple European regulators about fake Ozempic and Wegovy. Ireland’s Health Products Regulatory Authority (HPRA) said that, alongside the Irish customs agency, it had seized 159 units of semaglutide in the first seven months of 2023, compared with 32 units in 2022. “The online supply of these medical products to Ireland places their provenance outside the legitimate supply chain and therefore cannot be assured,” the HPRA said, adding it was closely monitoring the situation.
Illegal sales of semaglutide have also been detected in Belgium and Denmark, but regulators say these are mostly genuine products sold illegally online.
However, drugs regulators in Germany, Italy and France passed the buck. Germany said when it comes to the illegal supply chain, such as through the internet, the medicines regulator is not involved; the responsibility lies with the police and customs authorities. Italy directed POLITICO to the World Health Organization’s falsified medical products officer, and France merely shared its latest update on misuse of Ozempic by patients who do not meet the criteria to use the drug.
Stronger safeguards
The EU does have rules to protect people against fake medicines sold online, including an EU logo to identify legitimate pharmacy websites and track-and-trace barcodes on packages — but these are unlikely to protect people who are trying to beat the system.
“There is zero percent [fake drugs] going through the legal channels,” said Martino Canonico, public affairs manager at the European Association of e-Pharmacies (EAEP). “The issue of course is with the illegal channels.”
The surge in fake drugs has led some in the sector to question whether the current EU regulations are fit for purpose, especially in an age where scammers can set up fake online outfits with ease and purport to supply legitimate medicines.
More than 100,000 new domain names were registered online containing terms like “COVID,” “corona” and “virus,” in March 2020 alone, with criminal gangs exploiting the public health emergency. Today, they’re exploiting an online frenzy for semaglutide and, often, young people feeling pressured to look thin.
To Mike Isles, head of the Alliance for Safe Online Pharmacies (ASOP Global) in Europe, stronger safeguards are needed to protect patients when they buy meds online. He wants all online pharmacies globally to have a common domain name, ensuring they are vetted and legit. This is “my vision for the future,” he said. “So if it’s an online pharmacy in Germany, it’s .apotheke; if it’s in Spain, Portugal or Italy its .farmacia and for France its .pharmacie etc,” he said.
Oksana Pyzik, a lecturer at University College London’s School of Pharmacy, agrees — but also wants stronger rules requiring social media companies to report dodgy sellers to law enforcement, and much fiercer deterrents.
“Falsified medicines is a $200 billion dollar industry. It is in many ways the perfect crime with high rewards and low risk/penalties,” she said highlighting there are longer jail sentences for selling heroin than dangerous fake drugs.
“This is not like buying furniture off Amazon; unsafe fake prescription drugs can kill,” she said.