Is the online GLP-1 boom prioritizing profit over patients?

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Over the past two years, digital clinics have turned weekly GLP-1 injections into something that can be ordered from the couch, paid for with a credit card and delivered to the doorstep. One recent market forecast sees the entire GLP-1 category growing to roughly $100 billion by 2030, so it is no wonder that a flock of start-ups — and even a few established pharmaceutical giants — now court patients with “all-inclusive” monthly packages.​

A well-known weight management brand underlined the trend when it bought a virtual prescribing platform in 2023, instantly adding tens of thousands of remote members.​ Early the next year, another household name manufacturer opened its own direct-to-patient channel, letting people request tirzepatide refills online and pay cash if insurance balks.​

For many women juggling family, work and aging parents, this new front door feels wonderfully freeing. There’s no traffic, no childcare scramble and no surprise billing. The question is whether the speed and ease that make virtual subscriptions attractive leave enough room for careful, ongoing medical supervision.

The truth about bargain-basement GLP-1s

Gowri Reddy Rocco, MD
_{© Optimum Wellness & Longevity}

There is no doubt that virtual care widens the pathway for rural communities, shift workers and anyone who finds traditional office hours exhausting. Yet an eight-month review of online semaglutide vendors uncovered more than 1,000 active web links, and nearly half pointed to outlets already flagged as illegal. The same investigation noted a 15-fold jump in poison center calls tied to semaglutide.​ Separate lab testing of bargain-basement pens showed purity as low as 7% and alarming endotoxin levels — far from the quality you expect when the medication comes straight from a neighborhood pharmacy.​

Even when the drug itself is genuine, monitoring can slip through the cracks. Safe titration involves baseline kidney and thyroid labs, guidance on gall bladder symptoms, nutrition coaching and a kind ear for the emotional side of rapid weight loss. Algorithm-only platforms may approve a refill without verifying that any of those checkpoints happened. Little wonder that in a recent survey of 2,000 primary care physicians, two-thirds said they worry about risks when patients pick up GLP-1 prescriptions from third-party telehealth clinics. And in Medical Economics' own survey last year, a full 78% of physicians said they were concerned about their patients attempting to procure GLP-1 RAs from online sources without their knowledge.

The telemedicine clock ticks down on easy access

Because semaglutide is not a controlled substance, many people assume its online prescribing is unregulated. Not so. A federal rule issued in November 2024 extends pandemic-era telemedicine flexibilities only through Dec. 31, 2025; after that, stricter in-person requirements for controlled drugs may snap back and indirectly affect any clinic that mixes GLP-1 therapy with appetite suppressants such as phentermine.​

State borders add yet another layer. Fourteen states now insist that the very first visit for obesity medication occur over synchronous video, not an asynchronous form, while several others bar nonphysician ownership of medical practices — rules that reshuffle corporate and clinical responsibility.​ In short, both virtual start-ups and traditional offices that plan to meet patients online must budget for multistate licensure fees, prescription monitoring program checks and a solid compliance playbook.

What this means for clinic-based care

Every in-office follow-up for a patient on Ozempic or Wegovy usually brings in somewhere between $90 and $140. That revenue supports the registered dietitian, the pharmacist who resolves prior authorizations and the nurse who fields late-night nausea calls. When a patient signs up for a $99-per-month subscription that bundles those services elsewhere, the local clinic loses not only a visit but an ongoing relationship that once generated labs, imaging and referrals.

Still, this doesn’t have to be a zero-sum game. Some practices are launching their own hybrid memberships, like telehealth refills spliced between quarterly in-person checkups, so patients enjoy convenience without giving up hands-on exams or same-day lab draws. Others are striking collaboration agreements in which national apps send users to local clinics for baseline workups and visits for urgent issues. Health plans experimenting with value-based obesity contracts are already rewarding clinics that document sustained weight loss over 12 months, something far easier to prove when you control both virtual and face-to-face care.

Gentle guidance for patients and physicians

If you are a physician or other clinician with a patient tempted by that “Subscribe Now” button, or a patient yourself, pause for a breath and ask four things:

• Does the service ship factory-sealed pens?
• Will it order baseline and quarterly labs?
• Is there a live clinician you can reach at odd hours?
• Will it share your progress notes with your primary doctor?

A yes to all four keeps convenience and safety walking hand in hand.

If you lead a clinic wondering whether online prescribing is a good choice, remember that your superpowers are touch, teamwork and continuity. Bring those strengths into a hybrid model — perhaps with evening telehealth slots, transparent pricing and easy messaging.

Online semaglutide subscriptions can absolutely broaden access, especially for women who wear multiple hats and need flexibility. But access is only a true win when it is coupled with trustworthy medication, diligent monitoring and open communication. Blending virtual speed with brick-and-mortar depth offers the surest path to care that is convenient, compliant and, above all, caring.

With more than 25 years in the field of functional, regenerative and integrative medicine, Gowri Reddy Rocco, MD, is a leading expert in antiaging and optimal wellness. She is the founder and president of Optimum Wellness & Longevity in Corona, California, where she helps patients achieve their best health through a holistic blend of Eastern and Western medical practices.