Are third-party telehealth prescriptions of GLP-1s safe?

© Frogella.stock - stock.adobe.com

As demand for Glucagon-like peptide-1 (GLP-1) medications for weight loss surges, a new survey of more than 2,000 U.S. primary care physicians (PCPs) demonstrates growing concerns about third-party telehealth prescribing. According to findings released by Omada Health, two-thirds (67%) of PCPs believe that accessing GLP-1 prescriptions through third-party telehealth providers could put patients’ health at risk, with over half (57%) actively cautioning their patients against it.

“With expanding indications for GLP-1s gaining approval, the GLP-1 supply shaping up to be less of an issue, and a surge in telemedicine companies targeting patients with both branded and compounded GLP-1s for weight loss, prescriptions for these drugs will likely continue to increase,” said Wei-Li Shao, president, Omada Health.

“These findings underscore the importance of responsible prescribing to GLP-1s with oversight from primary care physicians within the medical home, which promotes coordinated care specific and relevant to what each patient needs to achieve healthy, sustained weight loss.”

Primary concerns

Among the chief concerns of PCPs regarding third-party telehealth prescribing are overprescribing (56%) and continuity of care (50%). Many physicians worry that patients who receive GLP-1 prescriptions without the involvement of their primary provider may lack proper follow-up, medication titration, and support for tapering off the drug when necessary.

Further complicating the issue, 61% of PCPs surveyed reported that their patients do not always inform them when they obtain a GLP-1 prescription from a third-party telehealth provider.

This lack of transparency, physicians say, can hinder their ability to manage side effects and provide necessary lifestyle interventions to ensure sustainable weight loss.

Physician hesitancy

The survey also revealed hesitancy among PCPs regarding compounded GLP-1 medications, which have gained popularity amid supply shortages of branded versions. Nearly seven in ten physicians (68%) agreed that compounded GLP-1s are less regulated, while 55% believe they are inconsistent. Another 47% consider them less safe than alternatives approved by the U.S. Food and Drug Administration (FDA).

Despite the shortages, only 30% of PCPs expressed comfort prescribing compounded GLP-1s, and 42% actively advise their patients against using them.

Additionally, there was a strong consensus among PCPs regarding the need to pair GLP-1 prescriptions with lifestyle modifications.

Roughly nine in ten physicians (87%) agreed that dietary changes are essential for effective weight loss with GLP-1s, while 79% emphasized the importance of exercise. Additionally, 88% highlighted the value of nutritional support, and 63% pointed to emotional eating interventions as critical factors for patient success.

Patients with comorbidities

PCPs reported that nearly 30% of their patients request GLP-1 prescriptions for weight loss, with physicians accommodating 53% of these requests. However, approvals were significantly more likely for patients with cardiometabolic comorbidities (75%) or diabetes (79%).

As the use of GLP-1 medications continues to rise, Omada Health’s survey findings are representative of a growing divide between traditional primary care and the rapid expansion of telehealth-driven prescribing. Without proper oversight, many physicians fear the long-term efficacy and safety of GLP-1 treatments could be compromised.

“Primary care physicians have the most comprehensive view of their patient’s medical history and ongoing care and are central to managing their overall health,” said Justin Wu, MD, VP of clinical innovation and quality at Omada Health. “There’s also a clear need for programs that provide support between office visits, offering proven wraparound services that address patients’ unique health needs — beyond focusing solely on the number on the scale.”