Insights into the thriving market for alternatives to branded weight-loss drugs

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Prescription weight-loss drugs have become so popular in the United States that manufacturers are struggling to keep up. Jean Readdy, a retired teacher from Sinking Spring, Pennsylvania, is one of eight Americans who have tried a GLP-1 drug for weight loss or diabetes, better known by brand names such as Ozempic and Wegovy.

Readdy, who has struggled with her weight for most of her life, told CBS News that her weight affects her self-esteem and the way she carries herself through life.

“I didn’t like going out,” Readdy admitted.

She reached her peak weight last October, shortly before her son's wedding.

“I was ashamed of him and I was ashamed of myself,” Readdy said.

Now she is one of a growing number of people who are turning to prescription drugs: reformulated versions that the FDA has allowed pharmacies to distribute during the ongoing shortage of brand-name drugs.

Readdy's decision to switch from a brand-name drug to one she made herself coincided with price and availability. Paying $1,200 a month for the brand-name drug Zepbound was unsustainable and it became impossible to obtain, she said.

And she is not alone.

Readdy turned to online communities where thousands of people shared resources and information about the scarce drugs. On a Reddit forum, she read about the side effects, learned about alternatives, and eventually came across a spreadsheet with dozens of telemedicine providers for prescription weight-loss drugs. After weighing the risks and calling dozens of pharmacies, she finally found one that would supply her with injectable tirzepatide, the same active ingredient as Zepbound. Readdy now pays $399 a month for her homemade drug.

CBS News identified more than 100 companies promoting access to tirzepatide or semaglutide, both active ingredients in branded GLP-1 drugs that regulate insulin and suppress appetite.

LegitScript, an organization that monitors and certifies online businesses, said the number of companies applying for its health certification has increased by 94% since 2023. More than half of recent applicants had a weight loss focus on their website.

However, compounded drugs are not reviewed by the FDA for effectiveness and safety.

“There's not too much oversight,” said CBS News medical contributor Dr. Celine Gounder. “There's a lot of variation in quality and risk.”

Researchers who ordered and tested mixed semaglutide found that some were contaminated and others contained more active ingredient than stated.

Compounded medications usually come with a needle and vial, not a prefilled pen like the brand-name medications. This can make administration difficult and lead to possible dosing errors. The FDA has issued warnings about administering the correct dosage of medications and the risks of using compounded semaglutide.

Yet many telemedicine companies that advertise over-the-counter weight-loss products present them as identical or “generic” versions of the brand-name drugs. Nearly a quarter of the websites identified by CBS News did not indicate that the drugs being advertised were over-the-counter.

There are no FDA-approved generics of branded weight loss drugs because the pharmaceutical companies still own patents on the drugs. Some of the companies falsely claimed that the drugs were FDA-approved. Some even allowed direct purchase without the required prescription.

The FDA is working closely with drug manufacturers and may restrict the manufacturing of compounded drugs as more versions of approved drugs are removed from the deficiency list.

Last month, Eli Lilly announced it would reduce the cost of the lowest dose of its drug Zepbound to around $400 a month and launched its own telemedicine company, LillyDirect.

Readdy, who has lost more than 50 pounds, said she intends to continue taking her prescription medications.

“We are very afraid that the drug will be taken away from us,” she said. “I believe it is a miracle drug.”