Business is apparently booming in the criminal trade for bogus obesity medicines. The Times (London) reports that criminals are selling dangerous weight-loss jabs on social media and in gyms. They write that:

“Pharmaceutical bosses have issued a stark warning about medicines such as Mounjaro sold online without safety controls as gangs branch out from hard drugs.”

For us, this reporting brings multiple dimensions of this deplorable situation into sharp focus. Obviously, the criminals who are selling bogus obesity medicines in settings almost guaranteed to harm people are commiting grievous offenses. But we would all do well to examine how we got here.

A Smidgen of Profiteering Here and There

Greed is a tricky thing. It is a dark part of human nature that easily sneaks into professional practices and can easily be taken for granted. Lately we have been seeing this in elected officials. Go figure.

But competition is supposed to keep profiteering under control. This often works quite well. Sometimes, though, it gets a little out of control. And this is indeed what seems to be happening in the market for highly effective obesity medicines like semaglutide and tirzepatide. When these medicines emerged, they transformed how the world looked at obesity and its treatment. Suddenly, people who had all but given up on doing anything about the devastating effects of this complex disease on their lives found themselves with good options.

Health Systems Stacked Against Patients

All this was great, except for one thing. Health systems were still stacked against those people. Understandably, drug companies who invested billions of dollars to bring this innovation to market expected to make billions of dollars of profit to reward them for the risks they took. That part is working out for pharmaceutical innovators.

But to make their money back, they had to price their drug high enough to make those profits from a small percentage of the people who actually need their innovative products. This was necessary because health systems systematically discriminate against people living with obesity. Health insurance imposes barriers to gaining coverage for these medicines or denies it altogether. Health professionals have long ignored obesity or put the burden on patients to deal with it on their own. “Change the way you’re living and this won’t be such a problem,” many of them effectively tell their patients.

Opportunities for the Unscrupulous

Where legitimate health systems – pharma, insurers, and providers – act in ways to keep desperate people from getting real help, unscrupulous operators are ready step in. Should we tighten the enforcement against these criminals? Absolutely.

But without solving the root problem of people being denied care, it will not work very well. People pointing their fingers at people who exploit a mess that they themselve helped to make does not look good for them.

Click here for the story in The Times. For a thoughtful reflection by OAC on the tension between access to care and loose regulation of compounding in the U.S., click here.

Stolen Money, photograph by Colin Brown, licensed under CC BY 2.0