Oral semaglutide (Wegovy; Novo Nordisk) launched in the UK on 6 July 2026 — the first glucagon-like peptide-1 (GLP-1) medicine that patients can take as a tablet rather than an injection. The Medicines and Healthcare products Regulatory Agency (MHRA) approved the drug one month prior, and pharmacies have been bracing for demand ever since.
Published on the day of launch, results from a National Pharmacy Association (NPA) survey revealed that three-quarters of pharmacies expect to start “significant numbers” of eligible patients on the pill, with almost half already reporting a rise in patient queries. With an estimated one in ten people experiencing needle phobia, the appeal of semaglutide in pill form is obvious.
However, the same NPA survey also raised significant concerns — that 97% of pharmacies are concerned the launch will fuel an increase in fake or unlicensed weight-loss medicines sold on the black market.
Kathie Cashell, chief executive of the General Pharmaceutical Council (GPhC), was blunt in sharing the same concerns. Criminals are “exploiting the significant public interest” in the drug to run illegal websites selling fake medicines that “don’t contain the ingredients they claim” and “pose a serious risk to health”.
A tablet, she points out, will be easier to counterfeit than an injectable pen.
Criminals are “exploiting the significant public interest” in the drug to run illegal websites selling fake medicines
Online criminals have been laying the groundwork for years. Since 2013, ‘prevention of future death’ reports issued by coroners have repeatedly warned the government and regulators that “future deaths will occur unless action is taken” against unregulated online drug supply.
In April 2026, results from an NPA survey of 100 distance-selling pharmacies revealed that one in ten had had their websites or social media presence cloned by criminals in the past year, while two in five had seen patients unwittingly buy weight-loss medication from unregulated providers. In one case, a patient bought a counterfeit Mounjaro (tirzepatide; Eli Lilly) pen, sold at one-quarter of the market price, that had no effect.
This was seemingly a lucky escape. In June 2026, Asda cited results from a survey of 267 GPs — carried out by Research without Borders — which revealed that 25% of respondents had encountered patients over the past year who required hospital care following complications from taking unregulated medication.
There has been a renewed effort to curb the problem.
- In June 2026, Asda Pharmacy launched a “judgement-free” disposal scheme across its 230 locations for medicines bought from unregulated sources;
- The MHRA’s criminal enforcement unit continues to work with police to seize unlicensed medicines and dismantle illegal medicine supply networks;
- From January 2026, the GPhC discontinued its internet pharmacy logo scheme after the logo itself was cloned on fake pharmacy websites;
- On 9 July 2026, the pharmacy regulator has launched a public safety campaign, with posters, videos and guidance advising how to check its online register to safeguard patients against purchasing from fake pharmacies.
However, a campaign that asks patients to check a register before they make a purchase still places the burden of vigilance on a subset of the public who may be particularly vulnerable, likely price-sensitive and looking for a rapid solution.
It has not helped that the legitimate route to treatment remains constrained
Malcolm Harrison, chief executive of the Company Chemists’ Association, has called for “tougher enforcement and meaningful penalties” against illegal sellers, while Sehar Shahid, an NPA board member, described current efforts as “a drop in the ocean” against what is becoming a sophisticated criminal enterprise.
It has not helped that the legitimate route to treatment remains constrained. MPs heard in June 2026 that just 1% of eligible patients are accessing weight-loss services on the NHS. The resulting “two-tier system” — a private prescription for those who can pay, versus a slower NHS pathway — is doing more than exposing deep health inequalities across the country. It is actively creating the economic conditions for a black market to thrive. When legitimate treatment is kept expensive or at the end of long waiting lists, patients flow down the path of least resistance.
What is needed first and foremost is an accessible, fast-moving NHS weight-loss service, delivered through the pharmacies patients already trust. NHS England told MPs that they were looking at the possibility of commissioning such a service but face financial and capacity hurdles in general practice. Community pharmacies, however, already support more than 1 million patients each month with weight management. Funding that role properly would do more to starve the black market of customers than any awareness campaign.
For patients who fall outside NHS criteria — and for the safety of anyone buying prescription medicines online — a robust, mandatory verification system is urgent. The NPA has proposed a protected ‘pharmacy’ domain name, which, unlike the voluntary logo scheme, would be much more difficult to replicate.
Neither fix is complicated and neither fix is optional. Patients deserve a system that moves at the pace of demand and not one that leaves them choosing between an unaffordable prescription, a lengthy wait or a website that might be selling them something worse than nothing. PJ
