Alarm over ‘quick prescriptions’ for GLP-1s online

The ease of accessing GLP-1 RAs is under the microscope after an American researcher posing as a ‘secret shopper’ patient was able to get a prescription from 45 of the 49 websites they tried.
 
The findings have caused those behind the study to sound the alarm, saying many direct-to-consumer platforms are prioritising ‘quick prescriptions over comprehensive care’.
 
While the study, published on Monday, was undertaken in the United States, Australian experts say they ‘wouldn’t be surprised’ if its results were echoed locally amid a rapid rise in single-issue telehealth prescribing.
 
For the study, US researchers used a simulated patient to explore the ease with which the viral weight-loss drugs could be accessed online.
 
The fake patient initially provided only upper body photos when requested, but ultimately received GLP-1 RA prescriptions from 91.8% of websites they approached.
 
The study found that all 49 websites used a questionnaire, 39 asked about weight loss goals, 32 asked about prior nonpharmacological weight loss attempts, and 26 about diet and physical activity.
 
All but one site asked about medical conditions, 46 about medications and allergies, and 27 about eating disorders.
 
Just 13 required a video visit and three required a call.
 
‘Several findings suggest limited oversight: multiple GLP-1 RA prescriptions from the same clinicians, prescriptions issued despite missing required photos, and prescriptions issued within five minutes or less,’ researchers concluded.
 
‘Additionally, this study found that compounded GLP-1 RA sellers asked leading questions about personalisation, added supplements, and modified formulations and dosages.
 
‘Limited clinician engagement, especially when prescribing compounded GLP-1 RAs with uncertain safety, efficacy, and quality may increase risks of medical and financial harm.’
 
RACGP President Dr Michael Wright said that while the US healthcare landscape is very different to Australia’s, the research highlights the college’s concerns about access to telehealth without access to people’s history.
 
‘When providing care for people managing excess weight and obesity, you need a whole-person approach, and just giving people a script over the phone really isn’t providing the comprehensive healthcare that people deserve,’ he told newsGP.
 
‘We’ve seen a number of services set up in Australia, particularly targeting single conditions like obesity, cannabis or ADHD, so it wouldn’t surprise me, given the amount of direct-to-consumer marketing, if those services are achieving similar results here.
 
‘It really does raise concern not only about the quality of care that people are getting, but how many health resources are going towards providing single-condition care.’
 
Dr Wright added that many single-issue telehealth services in Australia are ‘meeting a need, but not a need that improves people’s health’.
 
‘Comprehensive care involves being able to see someone in person and involves taking care of the whole person, not just a single complaint,’ he said.
 
The study comes amid a rapid rise in telehealth-only prescribing in Australia, with 118.2 million telehealth services delivered to 18 million patients between 13 March 2020 and 31 July 2022.
 
In 2024–25, 22.5% of people used telehealth services, down from a peak of 30.8% in 2021–22.
 
It has led to significant concern from the RACGP that telehealth is being substituted for routine in-person care.
 
‘Telehealth consultations between patients and providers unknown to each other should be limited to specific, clinically justified circumstances,’ the college’s position statement says.
 
‘Telehealth-only providers should actively promote continuity of care by encouraging patients to develop relationships with a usual GP or practice and seek consent to routinely and securely share consultation summaries with the patient’s usual GP or practice.’
 
The Federal Government is also in the process of rolling out further crackdowns, with a plan to compel telehealth-only services to share patients’ medication information by default to be in place by next year.
 
The US researchers said their study’s limitations include the use of a simulated patient profile ‘obscuring potential variability among patient experiences’, as well as no data being collected regarding follow-up after prescription.
 
Log in below to join the conversation.

GLP-1 obesity overweight single-issue telehealth telehealth weight loss