Amid the high cost and rising popularity of drugs used for weight loss like Ozempic, Mounjaro and Wegovy, pharmacists and medical doctors are warning consumers about some websites that sell discounted versions of the drugs.
When a consumer orders a drug online, they have no way of knowing what is in the medication, among other things, according to Dr. Konstantinos Spaniolas, director of the metabolic weight loss center at Stony Brook Medicine.
"Even if you assume that the medication is the correct substance, if this is not processed correctly and it's not sterile, there are infectious concerns," Spaniolas told ABC News' Becky Worley. "People really have to be careful because this leap of faith of ordering something that you are self-injecting at home is a big problem."
He added, "I personally, would not expose myself to that risk."
Ozempic, Mounjaro and Wegovy each require a prescription, and are not sold over the counter.
Ozempic and Mounjaro are approved by the U.S. Food and Drug Administration to treat Type 2 diabetes, but some doctors prescribe the medication "off-label" for weight loss, as is permissible by the FDA. Wegovy, which contains the same main ingredient as Ozempic, is FDA-approved for weight loss.
Insurance coverage for Ozempic and Wegovy varies, depending on everything from a person's medical diagnosis to where they live and their insurance plan.
Without health insurance coverage, the medications can cost over $1,000 per month.
Because of the high demand and high price for the drugs, some websites have started offering the drugs to consumers online.
"There's a huge percent of the population who is looking for these medications with limited access, whether … it's from insurance or availability," Spaniolas said. "Patients are trying to get the medications ordered online, but people have to be very careful."
Dr. Al Carter, executive director of the National Association of Boards of Pharmacy, told ABC News that many of the websites selling drugs like Ozempic and Mounjaro appear to be doing so illegally by operating without a license and by not requiring a prescription for the medications.
"There are around 30 to 35,000 pharmacies that are acting illegally," Carter said. "Our Digital Health team finds, on any given day, around 20 pharmacies, new pharmacies that are operating illegally."
Other unlicensed websites may promise a compounded version of a drug like Ozempic, which the FDA has warned against. Compound versions of drugs are made for individual patients using raw ingredients.
In June, the FDA warned consumers it had received reports of adverse events after people took semaglutide -- the active ingredient in both Ozempic and Wegovy -- that came from a compounding pharmacy. It did not specify the number of reports or what the adverse events were.
The FDA also said in the same warning that some compounding pharmacies claiming to sell semaglutide might instead be selling other formulations of the chemical, like semaglutide sodium and semaglutide acetate. Those haven't been shown to be safe or effective, according to the FDA.
Also in June, Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy, filed multiple lawsuits against certain medical spas, weight loss and wellness clinics, and compounding pharmacies for "the unlawful marketing and sales of non-FDA approved counterfeit and compounded semaglutide products claiming to contain semaglutide," including allegations of false advertising, trademark infringement and unlawful sales of non FDA-approved compounded products.
Red flags for consumers
Justin Macy, who leads the National Association of Boards of Pharmacy's Digital Health team, said one red flag for consumers to look for is websites that show photos of the drugs with unique United States-drug identification numbers, but then claim to ship out of Canada, which is illegal.
In other instances, websites posing as pharmacies may promote brand name versions of the drugs.
"The reason ... that this looks so legitimate is because this is the actual Wegovy website," Macy said of one example. "They totally just ripped off the manufacturer's website."
More red flags, according to both Carter and Macy, are websites that do not require a prescription in order to obtain the drugs, and websites that offer the drugs for well below the market price.
The FDA has resources on its website for consumers to use to determine whether an online pharmacy is safe, as well as a tool to search for state-licensed online pharmacies.
The National Association of Boards of Pharmacy also has a website, Safe.Pharmacy/a>, where consumers can verify online websites.