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

- Sheena Goodyear

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 di‐ abetes drugs like Ozempic.

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

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

"None of those medica‐ tions make you skinny."

BrandShiel­d, an Israelbase­d

cybersecur­ity com‐ pany hired by a consortium of pharmaceut­ical com‐ panies, says it took down more than 250 websites sell‐ ing 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 pharma‐ ceuticals.

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 di‐ abetes, but in recent years have become in high de‐ mand for weight-loss, gener‐ ating huge buzz from celebri‐ ties like Oprah Winfrey.

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

Many obesity specialist­s and endocrinol­ogists have extolled these drugs as an ef‐ fective 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 quickfix.

BrandShiel­d said it had 1,600 fake online pharmacies taken down last year, 279 of

which were selling counter‐ feit 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 prob‐ lem worldwide in the past few years, especially since COVID, with an increasing number of fake pharmacies and counterfei­ted drugs being sold online, and imper‐ sonations on social media," BrandShiel­d CEO Yoav Keren told As It Happens host Nil Köksal.

"This is a problem across industries, not only necessar‐ ily pharma. The big differ‐ ence here is that when you buy a fake drug, it can kill you."

Popular GLP-1 brands in‐ clude Novo Nordisk's Ozem‐ pic and Wegovy, and Eli Lilly's Mounjaro and Zepbound. Both drug companies are members of the Pharmaceu‐ tical Security Institute, which hired BrandShiel­d to target the counterfei­t sales.

BrandShiel­d said it had the fake pharmacy websites taken down by collecting evi‐ dence against them, and sub‐ mitting 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 com‐ pound versions semaglutid­e, Keren was adamant: "We're talking about totally counter‐ feited drugs. They have noth‐ ing 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 infor‐ mation.

CBC News hasn't indepen‐ dently 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 any‐ where in the world.

Lawrence Gostin, an ex‐ pert 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 prob‐ lem has only gotten worse with the proliferat­ion of on‐ line retail.

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

Risk in taking counter‐ feit drugs, says doctor

Gostin says food and drug agencies, including Health Canada, need to make a con‐ certed 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 regu‐ latory 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 Ser‐ vice 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 worse.

"The fact that there's no active drug, it's not coming from the manufactur­er, it's not covered by Health Cana‐ da, there's no regulation be‐ hind it - anything could po‐ tentially happen," he said.

In 2023, at least three people in the U.S. sought medical treatment for dan‐ gerously low blood sugar af‐ ter taking suspected fake ver‐ sions of Ozempic, according to Reuters.

The news agency reports there have been adverse re‐ ports connected to fake Ozempic reported in at least nine countries. it could be much

What's driving this market?

Wharton says there are a lot of factors that drive people to seek out GLP-1 drugs on‐ line. 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 Indige‐ nous. 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 ei‐ ther afraid to seek medical treatment for obesity, or are not listened to when they do.

"The majority of people, even people living with obe‐ sity 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 re‐ ally 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 coun‐ terfeit 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 ap‐ proach 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 pre‐ scribe drugs like Ozempic, she says, comes down to an individual patient's needs and health records - just like any medicine.

At his diabetes and obe‐ sity clinic in Burlington, Ont., Wharton says he and his col‐ leagues prescribe GLP-1 drugs to dozens of patients every day who meet the cri‐ teria.

That means patients who have Type 2 diabetes, a Body Mass Index (BMI) of between 27 and 30 with one comor‐ bidity 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 some‐ thing 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 mas‐ querade as well-known phar‐ macies 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 with‐ out a prescripti­on. GPL-1 medicines are prescripti­on only.

"If someone sells it with‐ out a prescripti­on, that's dan‐ gerous," he said.

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