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Consumer confusion fuels risky online drug purchases, survey finds
Due to widespread misunderstandings, many U.S. adults are buying drugs, especially GLP-1 products, from online, unlicensed sellers, a new survey reveals.
As more Americans turn to online pharmacies for cheaper, easier access to prescription drugs, two-thirds now say purchasing medicine online feels risky, up 22 points from 2023, a new national survey shows.
This finding comes as many people in the U.S. are buying unapproved versions of popular GLP-1 weight loss drugs from online sellers, despite most being aware of the risks involved.
The 2025 Alliance for Safe Online Pharmacies Foundation (ASOP) Consumer Behavior Survey, released yesterday, examines how Americans view, purchase and judge the safety of prescription drugs sold online, including GLP-1 medications.
The survey, conducted online in August by Abacus Data, used a random sample of more than 1,500 U.S. adults, intentionally oversampling GLP-1 users to ensure enough data for subgroup analysis.
All responses were weighted to reflect U.S. Census demographics and the actual GLP-1 population incidence, which is roughly 14%.
Building on previous surveys, the questionnaire included 60 questions regarding online purchasing behavior, product types, source verification practices and regulatory knowledge.
The majority of participants report purchasing brand-name medications (61%) and generics (71%) online, the survey highlights.
But many are also purchasing non-FDA-approved products, such as peptides (19%), customized medications (32%), compounded drugs (39%), and even goods marked "for research purposes only" (11%).
The report highlights that most Americans, including those who buy prescription drugs online, understand that online pharmacies must be licensed (80%) and that both brand-name and generic manufacturers are required to adhere to the same FDA quality standards (83%).
But despite knowing that, 65% mistakenly believe that online pharmacies and health service sites are reviewed or approved by federal or state regulators, with 44% thinking that prescriptions can be sold without a doctor's order if medical history information is supplied.
Most strikingly, a majority of Americans appear to confuse compounded drugs with FDA-approved products, the report notes, with 73% assuming compounded drugs are checked for safety and quality the same way as brand and generic drugs.
That percentage jumps to 80% among those who buy prescription drugs online and 86% for those who buy GLP-1 drugs.
This is especially troubling, given that 1 in 5 Americans uses online compounding pharmacies and nearly 4 out of 10 purchase compounded drugs through online sellers, the ASOP survey says.
Surging GLP-1 demand
The surge in demand for blockbuster GLP-1 drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) over the last several years is reshaping the online market while fueling new safety risks.
In fact, GLP-1 medications have become one of the fastest-growing drugs sold online. This increase is bringing many new consumers to online sites, including those that may not be verified, in search of more affordable versions of the patented products.
"Consumers are understandably drawn to the convenience and lower prices of online sellers, but that convenience often comes at the cost of safety," Justin Macy, board chair of the ASOP Global Foundation, said in an emailed statement.
Reported harms are significantly higher among people who buy GLP-1 drugs online compared with those who purchase other medications online, the survey underscored.
Among online GLP-1 buyers, 40% report receiving counterfeit or substandard products or were harmed by what they purchased, which is almost double the 22% reported by people who buy other types of medicines online.
"When consumers see new weight-loss or diabetes drugs promoted online, they may assume the products are legitimate, but that's not always the case," Carrie Harney, the Board President of ASOP Global, also said in the statement. "Verifying that a pharmacy is licensed in the United States is the single most effective way to stay safe.”
A vast majority (90%) of online buyers say they occasionally or always check the pharmacy's licensure status, while close to the same (91%) think the source they buy from is licensed in at least one U.S. state.
Less than 40%, however, check official sources, such as LegitScript, the National Association of Boards of Pharmacy or a pharmacy compounding accreditation board to confirm licensure.
Furthermore, 24% of online buyers have used an international pharmacy, and 59% have bought medications they thought were shipped from or meant for sale outside the U.S., despite 73% of buyers saying they only trust American sellers and 76% saying they only trust medications meant for the American market.
Overall, the survey pulls back the curtain on the widespread confusion most Americans have regarding medications sold online.
Alivia Kaylor is a scientist and the senior site editor of Pharma Life Sciences.
