Helping patients avoid obesity medicine scams

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It is clear the Glucagon-like peptide-1 receptor agonist (GLP-1 RA) antiobesity medicines are working. Patients want them. And they are not always willing to wait for their physicians to prescribe the new remedies — or for their insurance policies to cover them.

How likely are patients to skip their doctor’s orders and go shopping online for pharmaceuticals? In a fall 2024 survey by Medical Economics, 78% of respondents said they were concerned about their patients attempting to procure GLP-1 RAs from online sources without their knowledge.

But that leaves patients vulnerable to online rip-offs or worse –– getting drugs that are inappropriate or even harmful. With the U.S. Food and Drug Administration (FDA) pronouncing the drugs in shortage, compounding pharmacies have stepped in to fill the void, but that may cloud the situation, not clarify it.

“Patients are very confused about where they get the product,” said Tim K. Mackey, Ph.D., who has studied online fraud as a professor of anthropology at the University of California San Diego.

“Where is it legal to buy it? How easy is it to get it? What’s a compounding pharmacy versus the product coming from the legitimate manufacturer, like Eli Lilly or Novo Nordisk?”

Many physicians advise patients against seeking out compounded GLP-1 RAs, but some do prescribe compounded formulas. There are trustworthy compounding pharmacists in the market. Here’s some expert advice on how physicians can find them.

Get a pharmacy partner.

Physicians should develop relationships with trusted compounding pharmacists, not just for GLP-1 RA drugs. Compounding can expand the availability of treatments for patients.

“If you don’t already have a relationship with a local compounding pharmacy, try to create one. Reach out to them, meet them, get to know them and understand what the scope of their offerings are,” said Rob Nichols, Pharm.D., BCPS, is director of clinical operations for the Greenwood Pharmacy and Compounding Center of Waterloo, Iowa.

Ask questions.

A short conversation can reveal a lot about an organization, according to Tenille Davis, Pharm.D., a board-certified sterile compounding pharmacist and chief advocacy officer for the Alliance for Pharmacy Compounding (APC).

“Compounding pharmacists are helpful people; they’re problem solvers,” she said. “They’re happy to answer questions about their quality assurance procedures, testing procedures [and] where they source their active pharmaceutical ingredients. And if you’re talking to a pharmacy that’s hesitant to answer any questions like that, I’d find a different partner.”

Tell patients to ask questions too.

The same advice holds true for patients, Davis said. Tell them to ask questions and be wary if a pharmacist is not up front with information.

Use state resources.

APC operates “Is It Legit?”, a website that links to each state’s board of pharmacy so users can search for licensure, Davis said. Physicians or their staff should look for any negative actions regarding a pharmacy license and proceed with caution, Nichols said.

Ask about patient instruction.

GLP-1 RA drugs are injected, so doctors should ask pharmacists what level of counseling and instruction they must provide on preparing and administering injections. Nichols noted that different states have different requirements for counseling, but pharmacists should be willing to answer patients’ questions.

Look for insurance assistance.

Pharmacists and their staff may know about discounts or savings programs that patients and physicians may not be aware of. Many develop expertise in navigating patient insurance plans and prior authorization requirements, Nichols said. Doctors and patients should enlist their aid.

Stay local.

Nichols said organizations or companies from elsewhere have reached out to his company because they see “compounding pharmacy” in the name. Although resources may abound on the internet, he prefers to work with local providers, and physicians should consider doing the same when they can.

The full version of this article is available here.