0057Online Prescribing of GLP-1 Receptor Agonists: A Secret Shopper Study

Background Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and compounded GLP-1RAs—non-FDA approved GLP-1RAs—have become widely available online. Prior telehealth website review suggested limited clinician engagement in obtaining online prescriptions. The extent of clinical engagement and how closely online GLP-1RA prescribing aligns with care standards remain unclear. Research Aim We obtained GLP-1RAs from online sellers to characterize the prescription process and clinician engagement. Methods Using a simulated patient profile meeting GLP-1RA eligibility criteria (“Patient Sim”), one researcher attempted to obtain GLP-1RA prescriptions between August and December 2025 from previously identified websites advertising GLP-1RAs. This study was approved by Yale University’s IRB. Results The study included 49 websites, of which 45 (91.8%) prescribed a GLP-1RA and 32 (65.3%) sent the prescription to Patient Sim. Of the four non-prescribing, two required lab work, one denied based on an internal database indicating an existing prescription from another website, and one denied due to mismatch between Patient Sim’s photo and reported weight. All websites used a questionnaire to collect patient information. While 39 (79.6%) websites asked about weight loss goals, 32 (65.3%) asked about prior non-pharmacological weight loss attempts, 26 (53.1%) asked about diet and physical activity, and 27 (55.1%) asked about eating disorders (Table). Nine websites required a “full body” photo but prescribed despite only receiving an upper body photo. Thirteen (26.5%) websites required a video visit with a clinician and 3 (6.1%) a call. Three clinicians prescribed GLP-1RAs across two or more websites. Conclusions Online GLP-1RA prescriptions are based primarily on patient-reported questionnaires with minimal clinician interaction and rapid prescription approval. Is this an encore abstract? No