When Robin Langois, 58, was prescribed the diet drug Wegovy last year, she couldn't afford the high price because her insurance didn't cover it.
But she later discovered on TikTok that people could buy what appeared to be the drug's active ingredient, semaglutide, from compounding pharmacies for a fraction of the price.
Langva, of Tucson, Arizona, said she was initially hesitant due to safety concerns, but she eventually found a telehealth provider to write her a prescription.
“I'm not 100 percent sure that's what I got,” Langois said. However, she noted that she experienced feelings of fullness and weight loss, as well as nausea, which are common side effects of the drug. “It works like it's supposed to,” she said.
Because of cost or ongoing shortages, people are looking for alternatives to the brand-name drugs Ozempic and Wegovy, both of which contain the active ingredient semaglutide.
Some, like Langois, are turning to compounding pharmacies for hard-to-obtain weight-loss pills.
Novo Nordisk, the sole maker of Ozempic and Wegovy and the patent holder for semaglutide, said in a statement that it does not supply the ingredient to these pharmacies, leading some experts to question where pharmacies source the drug — and whether it is. semaglutide at all.
“It's a million-dollar question,” said Dr. Fatima Cody, an obesity specialist at Massachusetts General Hospital in Boston and a consultant to Novo Nordisk.
What is a compounding pharmacy?
According to the FDA, a compounding pharmacy mixes and alters drug ingredients to create a drug tailored to a specific patient's needs.
Compounded medicines are usually made using the active ingredients in medicines. In the case of Ozempic and Wegovy, that's semaglutide.
But compounding drugs — although they contain FDA-approved ingredients — are not themselves FDA-approved, meaning they're not regulated, monitored or tested by the agency, said Benjamin Jolly, director of Jolley's Compounding Pharmacy in Salt Lake City. Pharmacist and boss.
Hospitals sometimes use combination drugs when commercially available options are not ideal, according to the FDA. For example, they may lower the dose of pain medicine to prevent certain side effects, or remove preservatives or dyes that may cause an allergic reaction.
FDA spokesman Jeremy Kahn said the agency will also grant waivers that allow compounding pharmacists to make certain drugs in times of shortage.
Do compounding pharmacies offer real semaglutide? is it safe?
Dr. Chris McGowan, who runs a weight loss clinic in Cary, North Carolina, has noticed that a combination of Wegovy and Ozempic is growing in popularity.
“What I hear from patients is, ‘Oh, hey, I've heard of this compound semaglutide. Can I try it?'” he says.
Mary Morgan Mills, 32, of Raleigh, N.C., came to McGowan after taking the compound semaglutide for about a year.
She received weekly injections at the health center that made her sick, and she only lost about 15 pounds while taking them.
“I felt bewitched,” she said, adding that she had “a couple of bottles left in the fridge.”
“I've always wanted to test it out to see what it was, but I didn't know the process,” Mills said.
In many cases, compounding pharmacies aren't fully transparent about sourcing medications, McGowan said.
Jolley, who doesn't offer semaglutide, said compounding pharmacists may give people semaglutide sodium, a cheaper, modified version of the compound that's for research use only. However, semaglutide sodium is not FDA-approved, he said, which would make it illegal to sell the product.
Compounding pharmacists can also buy high doses of semaglutide from wholesalers and divide it into smaller doses or mix it with other drug ingredients, he said.
That basically dilutes the drug, said Matt Buderer, owner and pharmacist at Buderer Drug Company Compounding Pharmacy in Ohio, which he said doesn't make sense because it makes the drug less effective.
McGowan said that if compounding pharmacies offer semaglutide that isn't the actual drug, that's ultimately a safety issue because they may be using ingredients that haven't been fully evaluated by the FDA.
“What I tell patients is to be very careful when considering any form of combination semaglutide or combination tirzepatide, which is another drug that we're currently seeing being offered in combination,” he said. (Tirzepatide, a diabetes drug made by Eli Lilly, also has weight-loss benefits.)
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This article was originally published on NBCNews.com
