Inside the telehealth-fueled GLP-1 alternative market

The new class of GLP-1 weight loss drugs have been blockbusters since they arrived on the market a few years ago. These medications have made tens of billions of dollars for drugmakers and have made their way into the public consciousness in a remarkable way. 

Almost three-quarters of adults in the U.S. are overweight or obese, and obesity can lead to a litany of health complications, including heart disease, joint pain, and cancer. So there’s an enormous demand for highly effective weight loss drugs like Wegovy and Zepbound. 

Meeting that huge demand has been challenging. The name-brand medications are very expensive and not always covered by insurance. Even with coverage, consistent shortages of these drugs have plagued the market.

But there is a loophole filling this market gap. When name-brand drugs are in shortage, the FDA temporarily allows compounding pharmacies to make generic versions of these medicines. These specialized pharmacies, which typically make customized drugs for individual patient needs, have become a popular alternative for patients seeking GLP-1 prescriptions.

“So generally speaking, on the FDA drug shortage list, the majority of the drugs in shortage are going to be generics,” says Scott Brunner, CEO of the Alliance for Pharmacy Compounding. “Well, right now a couple of branded [GLP-1] drugs are in shortage. And by the way, they’re both blockbuster drugs. We’ve not been here before. And so it really is a rare instance that we find ourselves in when this drug with such incredible demand is in such severe shortage.” 

This has led to an explosion of telehealth companies offering compounded versions of GLP-1s at a much lower price than the brand-name products. This has meant big business for both telehealth companies and compounding pharmacies. But the future of this cottage industry, and the patients that have come to rely on the drugs they sell, is very much uncertain. 

In this deep-dive explainer video, STAT takes you through how exactly this alternative market for GLP-1s works.