MARY LOUISE KELLY, HOST:
Shortages of name-brand obesity drugs, like Wegovy and Zepbound, led to a boom in alternatives sold online. And these medicines are not generics but contain the same active ingredient. Now that the shortages are over, NPR pharmaceuticals correspondent Sydney Lupkin reports online sellers face two options - stop or adapt.
SYDNEY LUPKIN, BYLINE: When Chris Spears' pharmacy didn't have the obesity drug his doctor prescribed in 2023, he found another option while scrolling on Facebook. His feed was full of advertisements for cheaper alternatives to the name-brand medicine sold online through telehealth companies. They're called compounded drugs, and they aren't generics. They've been available for several years. That's because the Food and Drug Administration allows compounding pharmacies to make what are essentially copies of name-brand drugs when the agency determines those medicines are in short supply.
CHRIS SPEARS: The medication worked brilliantly. Absolutely phenomenal. But what I didn't enjoy was the experience was clunky.
LUPKIN: So he saw an opportunity and started his own telehealth company called OrderlyMeds. It serves about 40,000 patients a month. But the FDA has declared the name-brand shortages over. That means compounders, under the law, aren't supposed to make these copies anymore. Many compounders have already stopped making obesity drugs. On the other hand, OrderlyMeds is expanding its operations. The company will soon add 1 of 9 ingredients to its compound in obesity medicines based on patients' unique needs, which Spears says will help it follow the letter of the law.
SPEARS: And our goal is to actually leverage technology and enough data about any individual to, you know, create a version of personalized medicine that we feel actually meets what the FDA expected.
LUPKIN: It's one of many companies testing the FDA rules. But what's the difference between making essentially a copy of a commercially available drug and the personalized medicine companies like OrderlyMeds are planning to make? Here's Ameet Sarpatwari at Harvard Medical School.
AMEET SARPATWARI: Well, I think the line is not very well-defined, and I think that's why we're seeing certain companies who are willing to stay and test the waters.
LUPKIN: If online marketing is any indication, those waters are crowded. Last October, 40 ads for compound and obesity drugs launched on Facebook, Instagram and other Meta platforms. But in April of this year, nearly 2,000 launched. That's according to an NPR analysis of data from Meta's ad library on April 30. Many of the ads are for patches, droppers and pills, instead of the injectable forms the name-brand versions come in. Dr. Scott Isaacs, president of the American Association of Clinical Endocrinology, says these creative options could be a waste of money.
SCOTT ISAACS: None of these have been proven to be safe or effective. And without FDA oversight, there's no guarantee that these actually work, and there can be dosing errors.
LUPKIN: He says it's best to stick with FDA-approved drugs whenever possible. Still, the compounding era for obesity medicines has transformed this part of the drug industry, says Leigh O'Donnell, head of Shopper Insights at Kantar Media Market Research. It led consumers to search for alternatives online. Both Novo Nordisk and Eli Lilly, which make name-brand obesity drugs, now offer cheaper versions of their drugs through telehealth companies for people not using insurance. She's skeptical that compounders will be able to continue making their alternatives.
LEIGH O'DONNELL: The legality of this, especially for the biggest guys, is that compounding has sunsetted. Lilly and Novo do not have shortage problems, so don't get caught selling it.
LUPKIN: As for Chris Spears at OrderlyMeds, he says one day, companies like his won't be needed for people to access affordable obesity drugs, and he's OK with that.
SPEARS: I think the longer that the compounded option exists, the further the price gets driven down of the branded, which is overall just a good thing.
LUPKIN: Spears says he'll be happy to have played a part. Sydney Lupkin, NPR News.
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