Hundreds of websites are selling fake Ozempic, says company. Doctors say it's only going to get worse

Dr. Sean Wharton was not surprised to learn about a surge in shady websites selling what are alleged to be counterfeit versions of popular weight-loss and diabetes drugs like Ozempic.

Whenever a new drug dominates the market, he says, whether it's for cancer or cholesterol or erectile dysfunction, bad actors find ways to cash in.

"But this is, on scale, a hundred times bigger," said Wharton, an internal medicine specialist at Michael Garron Hospital in Toronto and assistant professor at the University of Toronto who researches obesity medicine, including studies paid for by the company that makes Ozempic. 

"None of those medications make you skinny."

BrandShield, an Israel-based cybersecurity company hired by a consortium of pharmaceutical companies, says it took down more than 250 websites selling fake versions of Ozempic and similar drugs in 2023.

Doctors and health-care law experts say this is part of the growing and dangerous problem of counterfeit drugs. It's an issue they say is likely to get worse — especially when it comes to this class of highly sought-after pharmaceuticals.

An 'extremely lucrative' business

Ozempic and other drugs in its class are known as glucagon-like peptides, or GLP-1 medicines. They were initially developed to treat diabetes, but in recent years have become in high demand for weight-loss, generating huge buzz from celebrities like Oprah Winfrey. 

Their active ingredient, semaglutide, promotes insulin production and also stimulates part of the brain that controls appetite. 

Many obesity specialists and endocrinologists have extolled these drugs as an effective treatment for what they say is a genetic, medical condition. But doctors have also urged caution, warning they come with potential side effects, need to be taken long term to remain effective, and shouldn't be seen as a quick-fix. 

BrandShield said it had 1,600 fake online pharmacies taken down last year, 279 of which were selling counterfeit drugs intended to treat metabolic conditions. Of those, it said more than 90 per cent were hawking fake GLP-1 medicines.

LISTEN | The pros and cons of Ozempic:

"This is a growing problem worldwide in the past few years, especially since COVID, with an increasing number of fake pharmacies and counterfeited drugs being sold online, and impersonations on social media," BrandShield CEO Yoav Keren told  As It Happens host Nil Köksal.

"This is a problem across industries, not only necessarily pharma. The big difference here is that when you buy a fake drug, it can kill you."

Popular GLP-1 brands include Novo Nordisk's Ozempic and Wegovy, and Eli Lilly's Mounjaro and Zepbound. Both drug companies are members of the Pharmaceutical Security Institute, which hired BrandShield to target the counterfeit sales.

BrandShield said it had the fake pharmacy websites taken down by collecting evidence against them, and submitting that to the service providers hosting the sites.

BrandShield says it uses artificial intelligence to scan websites for signs of fraud, and makes its final decisions about which ones to target in collaboration with its clients.

In some rare cases, it says, BrandShield tests the actual products themselves. 

Asked if these sites could be selling generic or compound versions semaglutide, Keren was adamant: "We're talking about totally counterfeited drugs. They have nothing to do with the original drug that you're trying to buy." 

In some cases, Keren says, the websites don't even send buyers any products at all, but are scams designed to steal people's credit card numbers and personal information.

CBC News hasn't independently verified BrandShield's claims about the weight-loss drug websites.

None of the sites cited in the report were based in Canada, BrandShield said, but their victims can be anywhere in the world.

Lawrence Gostin, an expert in global health law at Georgetown University in Washington, D.C.., who has been sounding the alarm about counterfeit for more than a decade, says the problem has only gotten worse with the proliferation of online retail. 

"Few people understand that the international market in counterfeit drugs is massive," he told CBC in an email. 

Risk in taking counterfeit drugs, says doctor

Gostin says food and drug agencies, including Health Canada, need to make a concerted effort to tackle the problem. 

"It isn't easy because they are ubiquitous and are highly professional and secretive," he said. "But we need strong laws and well-financed regulatory agencies to help stamp out this scourge."

Health Canada has issued warnings about counterfeit drugs in this country, and says it works with the RCMP and the Candian Border Service Agency to tackle the problem. 

Wharton says there's a huge risk in taking drugs from these websites. At best, he says, it's a saline solution that does nothing to help you. 

Or it could be much worse.

"The fact that there's no active drug, it's not coming from the manufacturer, it's not covered by Health Canada, there's no regulation behind it — anything could potentially happen," he said. 

In 2023, at least three people in the U.S. sought medical treatment for dangerously low blood sugar after taking suspected fake versions of Ozempic, according to Reuters. 

The news agency reports there have been adverse reports connected to fake Ozempic reported in at least nine countries. 

What's driving this market?

Wharton says there are a lot of factors that drive people to seek out GLP-1 drugs online. They're expensive, he says, and in some cases, not covered by insurance when used exclusively for weight loss. 

"Who has access to it right now? It's the rich. It's the privileged. It's not the Indigenous. It's not the immigrant populations. It's not Black women in the southern United States," he said.

Stigma and bias, he says, may also be driving people online, because they are either afraid to seek medical treatment for obesity, or are not listened to when they do.  

"The majority of people, even people living with obesity themselves, are biased against people living with obesity and feel that it's their own character flaw," he said. 

WATCH | Potential risks of Ozempic:

Dr. Mara Gordon, a family physician in New Jersey, says there are likely also cultural factors driving this market — ones that are unrelated to health, and deeply rooted in misogyny and racism.

"When people live in a really fatphobic culture, they'll often take really desperate measures to try to shrink themselves, try to make themselves take up less stakes in the world," she said.

"So I'm not shocked to hear that people are turning to sketchy websites, to counterfeit websites, to try to make themselves smaller in an effort to conform to the really narrow ideas of what bodies should look like."

Gordon practises what she calls a size-inclusive approach to medicine.

"Which means that I don't focus on weight. I don't direct my patients to lose weight," she said. 

Whether or not she'll prescribe drugs like Ozempic, she says, comes down to an individual patient's needs and health records — just like any medicine. 

At his diabetes and obesity clinic in Burlington, Ont., Wharton says he and his colleagues prescribe GLP-1 drugs to dozens of patients every day who meet the criteria.

That means patients who have Type 2 diabetes, a Body Mass Index (BMI) of between 27 and 30 with one comorbidity or complicating factor, or a BMI of more than 30.

But the demand for these drugs extends well beyond that, he said, pointing to a widespread "cultural desire for thinness."

"That's billions of people. So, when you have something like that, there's always going to be fake medications and opportunities," he said. 

What to watch out for

Consumers seeking these — or any — drugs online should always buy from a licensed, reputable pharmacy, Keren says. But he cautioned that some scammers will masquerade as well-known pharmacies to trick consumers. 

He recommends checking the URL for incorrect spelling. "If there's a typo, it's a scam for sure," he said.

Below-market prices are also a sign of trouble, he says. If the price looks too good to be true, he says, it probably is. 

But the biggest red flag, he says, is a promise to send you a prescription drug without a prescription. GPL-1 medicines are prescription only.

"If someone sells it without a prescription, that's dangerous," he said.