A new study from Yale School of Medicine reveals that online advertising for compounded versions of type 2 diabetes and weight-loss medications often misleads or only partially informs consumers. The research, published in January in JAMA Health Forum, highlights concerns about the practices used by compounding pharmacies to advertise these drugs.
Historically, compounding pharmacies have created custom medications for individual patients. However, due to a shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) since 2022, the FDA allowed these pharmacies to produce and sell their own versions of the drugs. As a result, online platforms offering these compounded medications have grown rapidly. A recent survey found that 11 percent of people using these drugs obtained them from online sources.
Unlike FDA-approved drugs, compounded drugs are not subject to the FDA’s safety, efficacy, or quality checks. Additionally, advertising for compounded drugs is less regulated than for FDA-approved drugs. While federal law requires prescription drug ads to be truthful, non-misleading, and accurate, the specific guidelines for compounded medications are unclear.
“The high demand for these drugs has created a situation with little oversight and widespread advertising,” said Alissa Chen, MD, MPH, a postdoctoral fellow and lead author of the study.
For the study, researchers conducted online searches between July and September 2024 to identify websites selling compounded versions of semaglutide, tirzepatide, or liraglutide. They found 79 pharmacies, and the results raised serious concerns. About 14 percent of these sites failed to disclose that the medications were compounded, and 37 percent implied or stated that the drugs were FDA-approved. Nearly half of the sites did not mention potential side effects, warnings, or precautions, while 40 percent made unverified claims about the drugs’ efficacy.
Ashwin Chetty, MD candidate and first author of the study, noted, “Our research shows that there are virtually no regulations in this area, which allows for misleading advertising practices.”
One of the most surprising findings, according to Chen, was that many websites advertised benefits such as reduced hair loss or improved sexual function. These claims were not supported by sufficient evidence to suggest they were achievable through GLP-1 RAs.
The advertising practices pose a risk to patients, said Reshma Ramachandran, MD, MPP, MHS, a co-author and assistant professor of medicine at Yale. Patients often turn to compounded medications because brand-name versions can be expensive. FDA approval offers consumers confidence that a product has been tested for safety and efficacy. Misleading advertising about compounded drugs, which have not been FDA-vetted, could lead to serious risks for patients.
“The fact that these pharmacies are not making it clear that their drugs are unregulated and untested could potentially harm patients,” Ramachandran said.
The researchers hope their findings will help shape future regulatory changes regarding the advertising of compounded drugs. “This study highlights the need for clearer policies,” said Joseph Ross, MD, MHS, professor of medicine and public health at Yale. “We hope the FDA will use our findings to ensure fair and transparent advertising by websites selling compounded GLP-1 RAs.”
Yale School of Medicine’s Department of Internal Medicine’s General Internal Medicine section focuses on patient care, research, education, and community health, with an emphasis on a generalist approach.
