Yale Study: Two-Thirds of Online GLP-1 Prescriptions Require No Clinician-Patient Interaction

A secret shopper study led by Yale School of Medicine researchers found 45 of 49 websites (91.8%) selling glucagon-like peptide-1 receptor agonists (GLP-1 RAs) issued a prescription to a simulated patient, and approximately 67% of online sellers required no interaction with a clinician at all.¹

The study, which was presented at the 10th Annual Heart in Diabetes Meeting, comes at a time when compounded GLP-1 RAs have proliferated online alongside partnerships between branded manufacturers and telehealth platforms, with nearly 1 in 8 adults reporting current use of a GLP-1 drug and close to 20% of GLP-1 RA users obtaining their prescriptions online.²

“While telehealth platforms have increased patient access to GLP-1 RAs, our findings suggest that some platforms do so through impersonal care that prioritizes quick prescriptions over comprehensive care,” wrote investigators.

Prior work from the same Yale research group reviewed website content alone and suggested limited clinician engagement in online compounded GLP-1 RA sales. The new study tested clinician engagement directly, using a simulated patient profile, dubbed Patient Sim, to solicit prescriptions from 49 websites identified as advertising GLP-1 RAs.^1,3

Online GLP-1 RA Prescribing Speed and Clinician Interaction Rates

Per study protocol, Patient Sim solicited a GLP-1 RA prescription from each of the 49 websites between August and December 2025, all of which sold either compounded or branded GLP-1 RAs and served patients in Connecticut. Every website relied on a questionnaire to collect height, weight, weight loss goals, and medical history, and 45 of 49 (91.8%) also incorporated a synchronous or asynchronous call into the process.¹

Across the 49 websites, 45 (91.8%) issued a GLP-1 RA prescription and 32 (65.3%) mailed the medication to Patient Sim. The median time from request to prescription was 1 day or less (IQR, ≤1-2 days), and 2 prescriptions (4.4%) were issued in 5 minutes or less.

Clinicians involved in the prescribing process were predominantly physicians, with MDs or DOs accounting for 28 of 49 websites (57.1%) and advanced practice registered nurses accounting for 17 (35.7%), while 4 websites (8.2%) offered no option to ask a clinician questions at all.¹

Compounded GLP-1 RAs, Added Supplements, and Prescribing oversight gaps

Among the 45 websites prescribing a GLP-1 RA, 39 (86.7%) issued a compounded formulation and 6 (13.3%) issued a branded product. Subcutaneous formulations accounted for 39 prescriptions (86.7%), with 5 (11.1%) sublingual and 1 (2.2%) oral. Added supplements, including vitamin B12, B6, B3 or NAD+, glycine, or carnitine, accompanied 27 of 45 prescriptions (60.0%), and 15 (33.3%) of all prescriptions included B12 specifically.¹

Oversight gaps emerged throughout the prescribing process. 9 of 45 GLP-1 RAs (20.0%) were prescribed with only an upper body photo despite a stated requirement for a full body photo or a photo on a scale. 34 (75.6%) were automatically charged and shipped once a prescription was approved, without a documented reassessment step.¹

Three clinicians issued GLP-1 RA prescriptions to Patient Sim across 2 or more separate websites. One website initially denied a prescription based on internal data indicating an active prescription elsewhere, then issued it once Patient Sim requested a refund. Of the 32 GLP-1 RA prescriptions Patient Sim obtained, the median supply was 1.0 months (IQR, 1.0-1.6) at a median price of $230.00 per month (IQR, $163.80-$294.70), with 30 sourced from 20 unique compounding pharmacies.¹

References

1. Chetty AK, Chen AS, Ross JS, Ramachandran R. Online prescribing of GLP-1 receptor agonists: a secret shopper study. Presented at: 10th Annual Heart in Diabetes (HiD) meeting; June 19-21, 2026; Philadelphia, PA.

2. Poll: 1 in 8 adults say they are currently taking a GLP-1 drug for weight loss, diabetes or another condition, even as half say the drugs are difficult to afford. KFF. Accessed March 8, 2026. https://www.kff.org/public-opinion/poll-1-in-8-adults-say-they-are-currently-taking-a-glp-1-drug-for-weight-loss-diabetes-or-another-condition-even-as-half-say-the-drugs-are-difficult-to-afford/

3. Chetty AK, Chillakanti M, Ramachandran R, Ross JS, Chen AS. Online advertising of compounded glucagon-like peptide-1 receptor agonists. JAMA Health Forum. 2025;6:e245018. doi:10.1001/jamahealthforum.2024.5018