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Yale University researchers were able to easily obtain GLP-1 prescriptions online using fake patient profiles, in some instances receiving prescriptions in less than five minutes and with minimal interaction with clinicians.
In a small study published on July 6 in the JAMA medical journal, researchers sought to obtain GLP-1 prescriptions through 49 websites using a “simulated patient profile” that met the eligibility criteria for GLP-1s.
Researchers made their attempts to obtain prescriptions between August and December of 2025.
All websites used questionnaires during the prescription process, with most asking about medical conditions, contraindications, weight loss goals, and medications and allergies. Researchers noted, however, that only 13 websites required a video visit while three required a call.
Only four websites denied prescriptions, with one being denied because a preexisting prescription had already been issued for the patient and another one being withdrawn because of a mismatch between the reported weight and the photo provided. Researchers were unable to get prescriptions from two other websites because they required blood work.
The median time to obtain a prescription was one day or less, with two prescriptions for compounded GLP-1s being issued within five minutes or less. Twenty percent of websites included in the study issued prescriptions solely based on an upper-body photo despite requiring full-body photos or a photo standing on a scale.
Three-quarters of the websites included in the study charged and shipped GLP-1 prescriptions automatically without confirming with the fake patient.
“This secret shopper study found that online GLP-1 RA prescription vendors often did not require clinician interaction, relying primarily on patient-reported questionnaires that may not capture important clinical and social history,” the study reported.
“Several findings suggest limited oversight: multiple GLP-1 RA prescriptions from the same clinicians, prescriptions issued despite missing required photos, and prescriptions issued within 5 minutes or less,” it continued. “While direct-to-consumer platforms have increased patient access to GLP-1 RAs, these findings suggest that some do so through impersonal care that prioritizes quick prescriptions over comprehensive care.”
The majority of the websites included in the study, 39, sold compounded GLP-1s. The researchers characterized questions posed by compounded GLP-1 sellers as “leading” about personalization, which they surmised was used to justify continued prescribing of compounded GLP-1s.
Under federal regulations, drugs can be compounded if they are in shortage or to personalize a medication for a specific patient, such as making a drug that’s normally a liquid into pill form. With no GLP-1s currently in shortage, compounding pharmacies that were able to openly sell GLP-1s for a few years had to transition away from selling these medications under Food and Drug Administration pressure.
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