Ashraf · Journal of medical Internet research 2024 · Market surveillance and laboratory chemical analysis · n=1080 search links, 6 test purchases (3 delivered vials analyzed)

Multifactor Quality and Safety Analysis of Semaglutide Products Sold by Online Sellers Without a Prescription: Market Surveillance, Content Analysis, and Product Purchase Evaluation Study.

Cited 25 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Laboratory bench analysis and market surveillance without human participants

PubMed 39509151 · doi:10.2196/65440 · record verified 2026-08-27

What was done

The authors evaluated online market availability, web traffic, and product quality of semaglutide sold without a prescription. They analyzed 1,080 search engine links, tracked domain traffic for illicit pharmacies between July and September 2023, and conducted 6 test purchases from illegal vendors. Delivered products underwent visual inspection, sterility and endotoxin testing, and quantitative analysis using liquid chromatography coupled with mass spectrometry.

What was found

Of 317 online pharmacy links, 134 (42.3%) led to 59 unique illegal pharmacy websites; the top 30 illicitly affiliated domains accumulated over 4.7 million visits over 3 months. Of 6 test purchases, 3 Ozempic pens were never delivered due to non-delivery scams. The 3 delivered injection vials were noncompliant with 59% to 63% of visual inspection criteria. Semaglutide content exceeded labeled amounts by 28.56% to 38.69%, while measured purity was only 7.7% to 14.37% (compared to 99% claimed). No viable microorganisms were detected, but endotoxins were present in all samples (2.1645 EU/mg to 8.9511 EU/mg).

Why it matters

Unregulated online purchases of semaglutide carry major safety hazards, including financial fraud, marked overdose risk from mislabeled dosing, severe chemical impurity, and pyrogenic endotoxin contamination.

Limits

The chemical and microbiological analysis was limited to only 3 delivered vials from 6 attempted purchases. The surveillance was cross-sectional, focused on a specific 3-month window, and did not evaluate human clinical outcomes or biological efficacy.

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