Loading summary
TED Talks Daily Host
Add a little curiosity into your routine with TED Talks Daily, the podcast that brings you a new TED Talk every weekday. In less than 15 minutes a day, you'll go beyond the headlines and learn about the big ideas shaping your future. Coming up, how AI will change the way we communicate, how to be a better leader, and more. Listen to TED Talks Daily wherever you get your podcasts.
Alex Goldman
This episode of Hyperfixed is brought to you by Mood Cannabis. Everyone's talking about it. Hey, I've heard of a can of soda, but a can of bis? I'm only joking. Listen, I'm getting reports from all my friends that this stuff is great. If only there was a company that thought cannabis should be accessible, affordable, convenient, and transparent. Oh, wait, there is. It's called Mood. Mood ships federally legal THC right to your door, and they found a way to combine THC with carefully selected functional ingredients to to target nearly every mood and health concern you can think of. I'm guessing that's why the company is called Mood. I'm talking about Mood.com's incredible line of functional gummies. And you can get 20% off your first order@mood.com with promo code HYPERFIXED. Forget one size fits all supplements that only get you high moods. Functional gummies get you absolutely rocked off your ass. I'm kidding. I'm kidding. I'm kidding. Moods gummies are optimized to kick in in as little as 15 minutes to you to the mood you're looking for. Whether that's mind magic gummies for deep work and creativity, PMS support to ease cramps and balance mood swings or their sexual euphoria. Gummies to help you feel ready for action and turn every touch into a full body experience. What do you think of that voice? It's just a thing I'm working on, I guess. Best of all, not only is every Mood product backed by a 100 day satisfaction guaranteed, but as I mentioned, listeners get 20% off their first order with code HYPERFIXED. So head to mood.com, find the functional gummy that matches exactly what you're looking for, and let Mood help you discover your perfect mood. And don't forget to use the promo code Hyperfixed when you check out to save 20% off your first order mood. Get rocked off your ass. I'm kidding. I'm kidding. I'm kidding. I'm kidding. I'm kidding. I'm kidding. This episode of Hyperfixed is brought to you by the An Arm and a Leg podcast. Ever gotten a medical bill that makes your brain freeze? You're not alone. An Arm and a Leg is the award winning podcast that dives deep into the question, why does healthcare cost so freaking much? Journalist Dan Weissman shares his investigative reporting with a personal touch and a sense of humor. Because if you don't laugh, you'd cry. Get answers to questions like why does an MRI cost $300 in one place and $3,000 in another? Why do bandages sometimes cost more than your rent? And what can regular people actually do when they're hit with sticker shock at the pharmacy? It's smart, clear reporting that not only helps you understand how the system really works, it gives you tools to fight back, make informed choices, and even save real money. And that kind of knowledge. It feels really good. Find An Arm and a Leg wherever you get your podcasts or@armalegshow.com hi, I'm Alex Goldman and this is Hyper Fixed. Each week on our show, listeners write in with their problems, big and small, and I try to solve them, typically over the course of a single episode. But if you've been listening for the last month, then you already know we're doing things a bit differently right now. Over the last two episodes we have been telling the absolutely massive story of how an illegal drug called GS441524 came to save the life of a little one eyed cat named Otto. In the first episode, we explained how this life saving cat drug came to be illegal and then how a group of renegade cat lovers built a black market pipeline to get the same illegal life saving drug into the hands of the people that need it. In our second episode, we explain how this cat drug black market went the way of so many other black markets. How in spite of so many good intentions and so much good work by so many good people, this group of renegade cat lovers found themselves waist deep in scandal and how that scandal ended up tearing that group in half. But the one thing we haven't yet explained is how just a few weeks after Otto completed his treatment regimen, this entire black market was rendered effectively obsolete. As of right now, GS441524 is available in pharmacies across the country. You can purchase it without fear of legal ramifications, and your vet can guide you through treatment without fear of losing their license. It's a whole New World for GS441524 and today for the final installment of the series, we're sitting down with one of the people who helped usher that new world into existence to tell you the story of how that came to be so Here it is. The Cat Drug Black Market, Part 3. The Cat Drug White Market. Hey, Nicole, thanks so much for giving us so much of your time to talk about this stuff.
Nicole Jacques
Yeah, no problem. I love talking about fip, so. So you've got, like, five hours for this, right?
Alex Goldman
This again is Nicole Jacques. In our last episode, you heard the first part of her story about how she joined a Facebook group called the FIP warriors, smelled something fishy, learned there was something fishy, and in the aftermath of that discovery, found herself getting excommunicated from the group. It was a tale of drugs, deception, and drama, one that, in the words of another former admin, probably would have made a really great reality show. But the reason we wanted to tell you that story is because it laid the groundwork for all of the really amazing stuff that happened next. So we're picking up right where we left off In March of 2023 that month, Nicole Jacques had just been punted from FIP Warriors. And she tells us nearly half of the admins and all. All of the moderators had chosen to leave with her. And in her exile, they had decided to start a new advocacy group, one designed to operate under a new, more egalitarian structure and guided by a new set of goals.
Nicole Jacques
And really, our goal was to, one, spread information about FIP treatment because, you know, there were still people who were. Their cat would get diagnosed, and their vet would say, like, oh, nothing you can do. Euthanize them. So first, you know, make information available that there was. There was treatment. But two, the way we put it was try to put ourselves out of a job, which was we wanted to get treatment, something that you could obtain legally under the guidance of a vet, so that you didn't need to come to a Facebook group like us.
Alex Goldman
Okay, so I guess I'm curious about, like, why you thought that was possible, because my understanding of the situation at the time was essentially that this could not become legal without FDA approval. And it couldn't get FDA approval unless Gilead, the company holding the patent, decided to pursue it. And they had explicitly said that they weren't going to do that. And, like, that's the whole reason the black market emerged in the first place. So what made you think that you could build a legal pathway to getting this drug?
Unnamed Contributor
So already before the schism, I had been. I'd been thinking about this a lot because it seemed very strange to me the position that we were in.
Alex Goldman
By strange position, Nicole means this issue with FDA approval. You see, long before Nicole started working with FIP warriors, she spent years volunteering with her local cat rescue. And it wasn't just like feeding the bottle babies and cleaning up the litter boxes type volunteer work. When Nicole was at the cat rescue, often what she was doing was assisting the veterinarian on duty and helping with overnight care for the cats that needed round the clock attention. And during the course of all that medical assistance, she'd given a lot of cats a lot of meds. And while those meds were prescribed by the veterinarians and obtained through legal channels, for the most part they were not FDA approved.
Nicole Jacques
You know, all along I've been sort of like, this is so weird, like, why are we stuck like this when, you know, other prescription medications for cats that aren't coming from an FDA approved manufacturer? It's very expensive, it's millions and millions of dollars to get a drug approved for one species. And we have all these species. There's never going to be a drug for every species we need a drug for. So we're already using an awful lot of the drugs that we normally use in veterinary medicine off label. And you could do treatment with your vet just like you would anything else. And I was like, wait a minute, that, that seems weird. Why, why can't we do this?
Alex Goldman
If all these other non FDA approved drugs were being legally prescribed, distributed and administered via pharmacies, Nicole wanted to know, why couldn't they do that with GS? And for years, the question had been festering in her mind. But once the group split, Nicole made it her mission to get the answer. And when she turned to the pharmaceutical law books, she found what she was looking for. And it turned out to be a two parter. Part one, the Animal Medicinal Drug Use Clarification act.
Nicole Jacques
Foreign.
Alex Goldman
So about 30 years ago, the FDA realized they had a problem on their hands. According to federal laws, it was illegal to use an FDA approved drug for animals in any manner that differed in any way from the drug's approved label. That meant that if you deviated from the dose, the duration, or the species that drug was meant to treat, you were in violation of the law. And obviously, like, this was a huge problem because as Nicole said, there weren't and aren't a lot of drugs that have received FDA approval for the treatment of animals, let alone each animal species specifically. So in 1994, a new law was written, the Animal Medicinal Drug Use Clarification Act.
Nicole Jacques
And the reason it exists is that the FDA, like realizes that, look, it's not realistic. We're not going to have, you know, an FDA approved drug for Every animal, for every possible disease that they could get. So they specifically have this guidance, which is, if there is not an FDA approved drug available, you are allowed to compound it.
Alex Goldman
You guys, they're allowed to compound it. Don't I sound very authoritative, like I know what I'm talking about. I mean, okay, I do know what I'm talking about now, but I definitely did not know what that meant when Nicole first mentioned it to me. And since I bet I'm not alone in that, here is my little PSA on compounding. So there are two types of pharmacies, compounding and non compounding. Non compounding pharmacies are the kind that most of us go to, like CVS or Walgreens. And these pharmacies are essentially just dispensaries. They receive drugs from manufacturers, they dispense them to consumers, usually without changing the medication at all. And that's where compounding pharmacies are different. Instead of simply dispensing premade medications, compounding pharmacies either alter the drugs or work with their active ingredients to make new forms of those medications. So let's say you have a horse that needs allergy medicine, or like a ferret that needs a treatment for the flu. These compounding pharmacies are where those medications are generally being made. They turn the drug ingredients into doses of medication that are appropriate for your specific animal species and in a form that can be easily administered. And According to this 1994 law, as long as everything that goes into those drugs is FDA approved and the compounding is done by a licensed pharmacist or veterinarian, those medications are totally legal. And the other fascinating thing we learned about compounding pharmacies is that because they're generally tasked with changing the medication in some way or another, they are, for the most part, legally shielded from claims of patent infringement, which is just like, very interesting to me. So what you're saying to me is as long as the drug is being mixed at an FDA approved facility and you're getting the drugs from an FDA approved manufacturer, these compounding pharmacies can just make the drug and the FDA will look the other way. Like that's how it works, right?
Nicole Jacques
Pretty much. So for, I mean, this is specifically to veterinary medicine, but yeah. And actually the thing is is that technically speaking, the vast majority of the compounding that is done for veterinary medicine falls under this.
Alex Goldman
Okay, so this 1994 law opened the door to compounding off label animal drugs that wouldn't exist otherwise. And again, all they needed was to be made in an FDA approved facility using FDA approved ingredients. This was great. This was wonderful. But eventually the FDA realized that this law was not enough, because as you already know from listening to this series, there was a significant need for animal drugs that were made from ingredients that had yet to be approved by the FDA. Which brings us to part two of our pharmaceutical law lesson, GFI 256. So in April of 2022, about a year before Nicole sat down and really started looking for a way to push GS out of the black market, the FDA released a new guideline for the veterinary industry. That's why it's called gfi, by the way, because it's a guidance for industry. And, you know, a lot of these guidelines are written in legalese, but this GFI seems to be saying, like, hey, you know, we know that there are situations out there where there's no FDA approved treatment option and for which no FDA approved drug can be used as the source of active ingredients for compounding. So in those cases, we acknowledge that it may be medically necessary to compound treatments from bulk drug substances. And although those medications still won't technically be legal, because they still won't technically be approved, we are explicitly giving our permission to do this as long as they're being made by licensed pharmacists or vets, as previously established in the 1994 law. And the bulk drugs came from a manufacturer registered with the FDA. So here's Nicole in 2023, fully immersed in the world of pharmaceutical law after years of operating in a black market that was filled with profiteering and unreliable meds, after years of being told that it was the only way to get GS into the hands of people that needed it. And she's reading about GFI256, and she's thinking, maybe things don't have to be this way. Like, maybe I'm misunderstanding what I'm reading, but maybe this is how we dig ourselves out of this dark and unsavory hole we've been operating in.
Nicole Jacques
And then I reached out to a contact in the FDA who was in their pharmacy, like, enforcement division. And I'm like, look, am I crazy or shouldn't we just be able to do this? And basically they looked at me, they're like, yeah, duh, that's why this is there.
Alex Goldman
Wow.
Nicole Jacques
This is not any different than anything else.
Alex Goldman
So. So this isn't even something you need to apply. This is literally something where you just need to say, if someone gets on your case about it, you're just like, well, I'm Doing this under the auspices of this particular carve out, you don't really need to go to anybody and be like, hey, I'm. I'm looking for approval here.
Unnamed Contributor
They were basically like, you don't need to ask for anything from. Because I was like. I was like, what do we need to do to be approved? And they're like, you don't need to be approved for this. You just. You do it. You get a pharmacy to do it.
Alex Goldman
So that's what Nicole did. She put together a pitch. She picked a major compounding pharmacy and said to them, hey, will you compound this for me? And they were just like, yeah, sure. It's crazy that it was, like, in the end, so remarkably not complex, but also, I'm sure it must have been a ton of work.
Unnamed Contributor
It was. And it was also somewhat hilarious in the sense that. So when I went to talk to one pharmacy, pretty large pharmacy, I mean, I literally came in with, like, a slide deck. I thought I was gonna have to convince them that this was okay to do, that there was a business case for doing it, that there would be support from the community for doing it. But, I mean, I really thought I actually had to tell them, like, that this would be an okay thing to do. And they were like, literally, it was like two slides in there, like, yeah, oh, we can. We can do this.
Alex Goldman
Obviously, this was a huge step forward, but there were still plenty of things that needed to be ironed out. And while they were in the process of doing that, Nicole caught wind of a major development in the GS landscape. Another American pharmacy, this one called Stokes, announced that they were going to begin selling compounded GS. Apparently, what had happened was that a pharmacy that was based in the UK and Australia reached out to them and said, hey, we've been compounding GS in our home countries, and it's been going great. Do you want to partner with us to compound this drug in the US And Stokes was like, hell, yeah, let's do it. Hell yeah, brother. Hell yeah, brother. Let's do it. So when news reached Nicole that there was already one pharmaceutical option coming, it was time for celebration.
Unnamed Contributor
This was like Christmas and New Year's and the Fourth of July and my birthday. This was the thing that. That we had been working for. I didn't care how we got there. I mean, I know talking to other people in the groups, when I kind of broke the news, you know, they were like. They were crying. So it was just. It was just joy. It was just like, oh, my God, we are there.
Alex Goldman
In June of 2024. Just weeks after Otto completed his treatment regimen, Stokes Pharmacy began selling the oral form of GS441524. And as of today, it's also in at least 15 other pharmacies, including national ones like Mixlab and Chewy. Thanks in part to the advocacy work of Nicole Jacques and her colleagues, it's still not technically legal, but as far as the FDA is concerned, it is officially and explicitly allowed. And to make sure there's no confusion on this point, the agency published a statement saying, quote, the U.S. food and Drug Administration does not intend to enforce new animal drug approval requirements for products compounded from GS441524 when prescribed by a veterinarian for a specific cat patient for the treatment of feline infectious peritonitis.
Unnamed Contributor
They specifically put out a letter saying, this is an approved use of the drug.
Alex Goldman
Oh, wow. So, like, you guys had enough clout that they were like, all right, well, we need to let people know that this is. This is kosher.
Unnamed Contributor
They literally. They were. They blessed it. They were like, this is exactly what you're supposed to do with GFI256. This is an allowed use. And they did quibble a little bit with. There was a lot of, like, we. People would say, like, oh, this is legal. Well, okay, so technically, it's not legal. It's allowed. It's splitting legal hairs. But they're like, yeah, this is legit.
Alex Goldman
So this whole journey has been bonkers. I mean, for us as reporters, certainly, and I'm sure for you as a participant, you know, working first in the black market and now being this advocate for pharmaceutical GS. And I guess my last question is about how you feel about this sort of black market now.
Unnamed Contributor
Well, when you have no other alternative and it's 100% chance of death versus not 100% chance of death, it's. Yes, it's a miracle. When you have something better, you should use the better thing. It's kind of like, when you think about it, like, there's. How many drugs have there been out there, like AIDS drugs? Right? There were a bunch of drugs that, like AZT and stuff like that in the early days of aids, that seemed like a miracle at the time because there was nothing else and you were gonna die. But now people will be like, oh, my God. Why would you take that? There's all these better drugs that have almost no side effects and control it really well. And, you know, like, medicine evolves. What seemed like a miracle yesterday is like stone age medicine tomorrow, you know?
Alex Goldman
Yeah, thanks. So much. Nicole, we really appreciate your time. After the break, we circle up with Marlena, the hyperfix listener who first set us on this path, and we tackle all the remaining questions we didn't have time to answer. This episode of Hyperfixed is brought to you by Babbel. So whenever I go on vacation to somewhere I don't speak the language, I learn like one useless phrase like do you have a glass of water? Or how much is that croissant? Or whatever. And then I just assume I'm good, like I'll use the one phrase and then once I've said it, the people in the country will be like, yeah, well, he tried. I'll just speak English to him. And as much as I'd like to convince myself that's how it works in a lot of the world, it doesn't. So that's why I use Babbel. Babbel has worked for over 16 million language learners of all ages and has over 1.6 million five star ratings. Learn everything you need, from vocabulary to culture while holding your own in conversation with anybody. With Babbel, it takes just 10 minutes a day. And Babbel has all these cool features to help you learn another language, like personalized review systems based on your progress. Designed for long term memorization, games for sentence building and spelling reinforcement, Babbel makes the process of learning a new language engaging and fun as opposed to a chore full of rote memorization. I want you to learn another language, so I'm teaming up with Babbel to gift you 55% off subscriptions, but only for our listeners. @babbel.com HYPERFIXED get up to 55% off@babbel.com HYPERLOCATED spelled b a b b e l.com HYPERFIXED babbel.com HYPERFIXELY Rules and restrictions may apply. This episode of Hyperfixed is brought to you by Quints. So do you want to know how, like, congenitally unfashionable I am? I had a shirt in high school that I loved so much that I found at a thrift store. It was for a baseball team called the Villains, and all it said on it was the Villains of Waterford Softball Club. And I liked it so much that when it became too threadbare, I gave pictures of it to a graphic designer so he could print new versions of my favorite T shirt and I could wear it all the time like a cartoon character, which is insane. Do not be like me. Use Quince instead. Quint's has closet staples. You'll want to reach for over and over like cozy cashmere and cotton sweaters for just $50, breathable flow knit polos and comfortable lightweight pants that somehow work for both weekend hangs and dressed up dinners. The best part? Everything with Quince is half the cost of similar brands. By working with top artisans and cutting out the middleman, Quint's gives you luxury pieces without the markups and Quint's only works with factories that you safe, ethical and responsible manufacturing practices and premium fabrics and finishes. I've never been much of a short sleeve button up shirt guy, but thanks to Quints, now I've been wearing them all summer and I feel like I'm in a J. Crew ad or something. I just like need some boat shoes or whatever. Whatever they wear, keep it classic and cool with long lasting staples. From quint Go to quint.com hyperfixed for free shipping on your order and 365 day returns. That's Q-U-I-N-C-E.com hyperfixed to get free shipping and 365 day returns. Quince.com hyperfixed welcome back to the show. So after a few weeks of telling you guys we're doing things a little differently, I am now here to say that we are back to our old hyper fixed ways. Which is to say now that we've spent three episodes trying to answer our listener Marlena's question and at least a few additional questions she didn't even know she had, we circled back up with Marlena to get her thoughts. I'm curious, like when you heard that this was going to be a three part story, what you thought this story was going to be versus what it ended up being?
Marlena
I don't know. I don't know what I thought. I did not expect it to be this dramatic of a, I don't know, like ring of Facebook moms. Like I didn't expect it to be so much weird petty drama. And I had wondered if they were profiting off of it. I kind of assumed they were, but I didn't think it would be as much as it maybe was.
Alex Goldman
I'd like to think that usually we have a pretty definitive answer for our hyperfix guests. Like yes, you can sit on public toilets and no, those green hex code license plates are not part of some conspiratorial cabal. Sadly. But with this story we knew even our best answers just begged more questions. And Marlena had a few. So I invited Sari Sofer Sukanek, who is the lead reporter on the story, to Join me in answering them.
Marlena
So can you still get it illegally or is it all now through compounding pharmacies?
Sari Sofer Sukanek
Oh, no. There's still definitely an illegal market, and a lot of people get caught up in it. Even though pharmacies now carry GS, one of the struggles is that this information has been slow to get out. So we've heard that even some vets will still refer people to FIP warriors either for drugs or for support. And FIP warriors is still referring people to black market meds. That's at least as of May of this year. Which is the latest version of an FIP warriors approved drug list that we were sent. On that list, most of the drugs are black market.
Marlena
Okay.
Sari Sofer Sukanek
Though there are now a few compounding pharmacies on it as well.
Marlena
Wow.
Sari Sofer Sukanek
Yeah. And we asked Robin, the founder of FIP warriors, about why they still have so many black market meds on their list, and she argued that there's really not that much of a difference between the black market and pharmacy drugs.
Alex Goldman
If it's okay with you guys, I'm just going to play that part of the interview with Robyn.
Unnamed Contributor
So it's an interesting gray area that the compounding treatment falls into, but it's definitely one that many people feel more comfortable with because there is more of an a feeling of legitimacy since you can have your vet send the prescription in and the pharmacy will mail it to your house. It's a little less cloak and dagger that way. But bear in mind, you know, the loophole means that even the compounded meds through the pharmacies are not FDA regulated. So are they that different from the ones in the open market?
Sari Sofer Sukanek
I mean, I think that's one way to look at it. Another way to look at it is that when you're getting medication from a compounding pharmacy, a licensed pharmacist is mixing everything and putting it together. And your licensed vet can oversee the treatment. So it's of course, a little different. But I will say I did speak to an ex warrior who gave a pretty intriguing explanation to me as to why FIP warriors is often quicker to recommend black market meds and might even deter people from the pharmacy meds. And I know what you're thinking, Alex, but her reasoning was not money.
Alex Goldman
Uh huh. All right, well, let's hear her reasoning.
Sari Sofer Sukanek
Well, she wanted to stay anonymous, but I'll summarize her argument for you, which is that she doesn't feel comfortable advising parents using pharmaceutical drugs because that's illegal. It's a criminal offense to provide medical advice without A medical license. And even though it was obviously illegal to provide medical advice on an illegal substance with the black market meds, too, she said here she'd be going against a vet and interfering with a patient doctor relationship. So she said it's not that she personally would push people away from pharmaceuticals, it's just that she didn't feel comfortable helping with that sort of treatment. She also said that all her experience in the tens of thousands of cases was with black market drugs, so she feels confident in her treatment protocol there. And she suggested that she isn't necessarily sure that a vet who has just started being able to prescribe this treatment has the same type of experience.
Alex Goldman
Okay, fine. I kind of get that.
Marlena
Yeah.
Sari Sofer Sukanek
Oh, and one last thing, just to go back to the question of black market meds. Marlena, one reason that Robin told us that they still use them is that the majority of the compounding pharmacies are only offering GS in the oral form, and sometimes that's just not the right treatment route. She said it's often better to start with injectables since they can be more effective at crossing the blood brain barrier. And some cats can't tolerate the pills at first, though, you know, that argument is obviously disputed in other sources circles.
Marlena
So I kind of believe what they're saying about needing the injection at first, because he also started on injections and then later went to pills.
Alex Goldman
Oh, so Otto was, like, using injectables when he was very sick, and then his admin switched him to pills once he got the all clear?
Marlena
Yeah.
Sari Sofer Sukanek
Oh, interesting. Well, yeah, Marlena, that was an extremely long winded way of saying, yes, there are still black market meds being used. What other questions do you have for us?
Marlena
Are they still making money off of it? It seems weird that they would want to stay in the black market business if there's no longer a profit.
Sari Sofer Sukanek
Oh, yeah, I was waiting for this question. So there are some ex warriors who say there's definitely money being made still. One former admin who left warriors about a year ago told us that when she left, she was still making commissions off selling the drugs.
Alex Goldman
Well, I mean, even when we talked to Robin in May of this year, she didn't say that no one was making commissions anymore. She said. She said people making commissions are down to barely any at all and that they're primarily 100% volunteer. So, you know, like, not 100%.
Sari Sofer Sukanek
Yeah, but here's where things have potentially changed. One ex warrior who left just a few weeks ago. Actually, she told us that the warriors had moved to a different type of profit structure, more like a pay for play type of model, which is where in order to get on the warriors list of approved meds, there had to be some sort of financial arrangement. She said they're hidden because they're sort of like donations to the group, but then you get prime real estate on the brand list.
Alex Goldman
Dude, that is really sketchy.
Sari Sofer Sukanek
Yeah. She wasn't the only one that said that either. No. Robin denied the group as making any money or was being paid by any brands. And it was kind of hard to get in touch with anyone else that's still involved in FIP Warriors. The ex Warrior who I mentioned that left a few weeks ago also told us that the group is kind of a shell of itself. Now. As you know, we spoke to numerous admins that left because they eventually got fed up with the financial incentives or felt that some of the practices were unethical. And now, apparently, most of the admins are totally new and there are much fewer of them. It seems like all the money stuff sort of caught up to the group, and they're struggling to survive in this new world where you can access the meds and pharmacies.
Marlena
Yeah. And my only other question was, is, did anyone else ever get investigated for selling them, or is it just the one woman who got raided?
Sari Sofer Sukanek
Just the one woman.
Marlena
Wow.
Sari Sofer Sukanek
I know. I know. They were making an example out of her.
Marlena
Yeah.
Sari Sofer Sukanek
And it sounded like the sheer volume at which she was doing it was exceptional.
Marlena
Yeah.
Sari Sofer Sukanek
Okay, Marlena, now one question for you. How is Otto doing these days?
Marlena
He's good. He's. He's good. For a while, it felt like he had, like, a bit of a plague upon him because it was just, like, one thing after. There was, like, the eye and then the fip, and then he got this weird rash, I think, from the injections, and now he still has some, like, bald spots from that. And so it was like, one thing after another. And I was like, this cat's just. Something's gonna get him eventually. But he seems to be good now. He's also calmed down from when he was a kitten, so he's still destroying stuff, but not on the daily basis, which is a little bit nicer.
Sari Sofer Sukanek
Marlene, I think we're good to go. Thank you so much. Thank you for being so available through all of this reporting. I know I've texted you a lot and made you look in your DMs many, many times.
Marlena
It's been. Yeah. Way more than I was expecting.
Alex Goldman
Yeah, us too. All right, well, thank you so much.
Marlena
Yeah. Thank you, guys.
Sari Sofer Sukanek
Alex, you still there?
Alex Goldman
Yeah. What's up?
Sari Sofer Sukanek
Okay, so I'm really glad we got to answer all of Marlena's questions, but we also did get a couple questions from some other hyper fixed listeners on our Discord that I think we should address.
Alex Goldman
All right, let's do it.
Sari Sofer Sukanek
Okay. Here's our first caller.
Discord User
Hi. Rather be squidding from Discord here. I've been fascinated by the cat drug black market episodes you've been putting out, but I have noticed that the black market here has been painted in a pretty positive and helpful light, which, you know, obviously, because it's helping out these cats. But presumably there is a reason why prescription drugs need a doctor or a veterinarian to prescribe them. So, you know, I'm wondering, you know, did this black market for this cat drug have any public health risks? You know, I guess, you know, ultimately, I'm wondering, are there any downsides to this black market that, you know, haven't been addressed in these episodes?
Alex Goldman
Okay, thanks for the question. So the first thing that comes to mind is the fact that there were definitely instances where people got bad drugs, and we talked about one of those in the first episode. It was really early on in the FIP Warrior history. Some of the cats started backsliding and not getting better from the meds, and the group eventually found out that they had some bad meds in the mix from one company and eventually pulled the cats off of it. And that happened again throughout warriors history. It, like, wasn't just isolated to that moment. In fact, on the next bonus feed, you'll hear from a pet parent whose cat got bad drugs in 2022. And although the cat did live, he suffered long term complications. And it is a pretty heartbreaking story.
Sari Sofer Sukanek
Alex, you know what else this reminds me of? It's something that Nicole Jacques said to us in our first interview with her. It's less about the actual health risks to cats, but a more general public health risk when the black market was.
Nicole Jacques
The only option, aside from the efficacy of the treatment, any side effects or stuff like that. The more medical aspect is also just how is this phenomenon of people getting treatment from the black market and these Facebook groups that were taking the place of vets in a lot of ways. How is that affecting people's relationship with veterinary medicine, their relationship with their vets?
Alex Goldman
Great question. Because you're in this situation where the only lifesaving drug you can get for your cat needs to be procured on the black market with questionable dosage information like you're still potentially endangering your pet.
Nicole Jacques
Yes. So like, does this set people up for, you know, great things work this time so they're going to be more likely to engage in this behavior later where maybe it won't turn out quite so well.
Sari Sofer Sukanek
Okay, last question from Hyper Fixed listener, Ellie Roberts.
Ellie Roberts
Hi, Emma and Sari and Jo and Amor and Tony and Malix. My question has to do with time. I'm really curious, kind of at which point you decided this was a multi part story. How many hours of interviews you did for this one and yeah, just kind of how the story shaped itself into, you know, your first three part episode.
Alex Goldman
Thanks.
Ellie Roberts
Love you guys.
Alex Goldman
Glerp it.
Ellie Roberts
Bye.
Alex Goldman
Siri, do you want to take this one?
Sari Sofer Sukanek
Sure. Well, actually, can I phone a friend?
Alex Goldman
Yes, you can. But who are you hoping to phone?
Sari Sofer Sukanek
Hyper Fix producer and editor Emma Cortland. Of course. Emma.
Marlena
Oh my God.
Sari Sofer Sukanek
Yeah.
J
Okay, so we decided, I think that this was going to be a two part episode and actually I think that we announced that at some point that this was going to be a two part episode. So we've decided that during the outline phase and then as we were writing episode two, I think we realized, oh, there's just too much information here. We have to make it three episodes. Technically I feel like this was two and a half episodes, but yeah, I mean, so ultimately it's like there were just so many characters, there was so much information. I still don't know if we made the right call. But here we are, we're at the end and I hope to never talk about Cats again.
Sari Sofer Sukanek
I mean, I frankly think it could have been a 10 part episode with how much information we had and how many characters there were. But for the sake of our time and everyone else's time, I think we did probably make the right choice. And I do want to answer Ellie's other question, which was how many hours of interviews do you think we did?
J
I mean it was easily over 20 hours. I think that we spoke to. I know that we, because I counted. I know that we spoke to a dozen people and many of them we spoke to multiple times. And it's not even counting. That's just like actual verbal communication. This is not counting the emails that went back and forth, the text messages, the exchange of pet pictures. This was our biggest reporting project yet and we didn't even do it on purpose.
Sari Sofer Sukanek
So true. Also, I don't know about you, Emma, but by the end I did feel like we were talking to like celebrities. I feel like once we got deeper into the reporting, we realized how small this world is and how despite all their differences and the drama that unfolded between them, these people are kind of legends in the world of fip. I mean, we spoke to the guy that figured out that GS was the cure for fip. We spoke to the OG cat ladies that were saving kittens from this deadly disease when even the vests of the world couldn't. And many of them, even after they left FIP warriors, even if they're not part of any other group, they continue to recommend treatment and advise pet parents because they really just have so much experience treating FIP at this point, more so than pretty much anyone else.
J
Let's do a dog story next.
Sari Sofer Sukanek
Or wouldn't you like that?
J
I know I really would. I'm done with your cats. Okay, guys, I think that's it. Is it awesome?
Sari Sofer Sukanek
I think it's it. Alex, what do you think?
Alex Goldman
I'm done. I'm all set.
Nicole Jacques
All right, guys.
J
Bye.
Alex Goldman
Bye.
Sari Sofer Sukanek
Bye.
Alex Goldman
This episode of Hyper Fixed was produced and edited by Emma Cortland, Amore Yates and Serious Offer Sukenik. It was hosted by me, Alex Goldman. The music is by the mysterious Breakmaster Cylinder and me. The show is engineered by Tony Williams. A huge thanks to our fact checker Naomi Barr, who we couldn't have done this story without. And a special thanks to Sarah Ellis for the COVID art. You can get bonus episodes. Join our discord and more@hyperfixpod.com join next week on the premium feed. We have our final cat story. For now anyway. We are talking to a pet parent who enter the whole FIP Warriors GS experience. Hyperfixed is a proud member of Radiotopia from prx, a network of independent creator owned listener supported podcasts. Discover audio with vision at Radiotopia fm. Thanks so much for listening Radiotopia.
Unnamed Contributor
From prx.
Hyperfixed Episode Summary: "The Cat Drug Black Market, Part III"
Release Date: August 14, 2025
Podcast: Hyperfixed
Host: Alex Goldman
Network: Radiotopia
In the latest installment of Hyperfixed, Alex Goldman delves deeper into the intricate world of the cat drug black market through a compelling three-part series. This episode, "The Cat Drug Black Market, Part III: The Cat Drug White Market," serves as the conclusive chapter, unraveling the transition from an underground black market to a more regulated and accessible legal framework for the crucial feline drug, GS441524, which has been instrumental in treating Feline Infectious Peritonitis (FIP).
Alex sits down with Nicole Jacques, a pivotal figure who played a significant role in shifting GS441524 from the shadows of the black market to the legitimacy of compounding pharmacies.
Key Highlights:
Formation of a New Advocacy Group:
After being ousted from the original FIP Warriors Facebook group in March 2023, Nicole and nearly half of the group's administrators established a new advocacy organization. Their mission was twofold:
Nicole Jacques [06:47]:
"Our goal was to spread information about FIP treatment and try to put ourselves out of a job by making treatments legally accessible through veterinarians."
Understanding Pharmaceutical Legislation:
Alex challenges Nicole on her optimism regarding the legal accessibility of GS441524 without FDA approval. Nicole explains her extensive background in veterinary medicine and her realization that many veterinary drugs operate under similar legal frameworks, often without specific FDA approval for each species or condition.
Alex Goldman [07:23]:
"Why couldn't we do the same for GS441524?"
Navigating the Legal Maze:
Nicole uncovers the nuances of the Animal Medicinal Drug Use Clarification Act (AMDUCA) of 1994 and the FDA's Guidance for Industry (GFI) 256 released in April 2022. These regulations provided a loophole allowing compounding pharmacies to produce GS441524 legally, provided they adhere to specific guidelines.
Nicole Jacques [10:09]:
"The FDA realized it wasn't realistic to have an approved drug for every animal and condition, so they allowed compounding under certain conditions."
Establishing Compounding Pharmacies:
Leveraging the new guidelines, Nicole collaborates with major compounding pharmacies to manufacture and distribute GS441524 legally. The breakthrough comes when Stokes Pharmacy, influenced by international partners, begins offering compounded GS441524 in the U.S. market.
Nicole Jacques [16:25]:
"They were like, yeah, duh, that's why this is there."
FDA Endorsement and Market Transformation:
The FDA's official statement endorsing the use of compounded GS441524, as long as prescribed by a veterinarian, marks a significant victory. This shift effectively dismantles the black market, making the drug accessible and regulated.
Alex Goldman [19:07]:
"The FDA published a statement saying, 'the U.S. food and Drug Administration does not intend to enforce new animal drug approval requirements for products compounded from GS441524 when prescribed by a veterinarian.'"
Post-interview, Alex reconnects with Marlena, the listener who initiated the series with her inquiries.
Discussion Points:
Continued Existence of the Black Market:
Despite the emergence of legal avenues, the black market for GS441524 persists. Reasons include slow dissemination of information and the preference for injectable forms over oral medications provided by compounding pharmacies.
Sari Sofer Sukanek [28:08]:
"There’s still definitely an illegal market, and a lot of people get caught up in it."
Profit Motives within the Black Market:
Allegations surface that some former administrators of FIP Warriors continue to profit through commissions and financial arrangements, undermining the nonprofit facade they once maintained.
Sari Sofer Sukanek [32:35]:
"They have moved to a different type of profit structure, more like a pay-for-play model."
Public Health Risks and Veterinary Relationships:
The black market poses significant public health risks, including the distribution of substandard or counterfeit medications. Additionally, reliance on illicit channels strains trust between pet owners and veterinary professionals.
Alex Goldman [35:00]:
"There were instances where people got bad drugs... a pet parent whose cat got bad drugs in 2022 suffered long-term complications."
Nicole Jacques [36:40]:
"Does this set people up... so they're going to be more likely to engage in this behavior later?"
The episode continues with Alex and reporter Sari Sofer Sukanek addressing further questions from listeners:
Public Health Implications of the Black Market:
Alex Goldman [35:38]:
"People got bad drugs... it's not just isolated incidents."
Extent of the Black Market's Persistence:
Future of GS441524 Access:
As the series concludes, the episode reflects on the monumental shift from an illicit trade to regulated access for GS441524, emphasizing the resilience and dedication of advocates like Nicole Jacques. However, it also underscores the lingering challenges posed by the black market, profit-driven misconduct, and the necessity for sustained advocacy and education to safeguard feline health.
Alex Goldman [40:49]:
"Or wouldn't you like that? I know I really would. I'm done with your cats."
Despite the exhaustion, the team acknowledges the importance of sharing Otto's story and its broader implications for veterinary medicine and pet owner communities.
Notable Quotes:
Nicole Jacques [10:59]:
"If there is not an FDA approved drug available, you are allowed to compound it."
Alex Goldman [13:31]:
"So, what you're saying to me is as long as the drug is being mixed at an FDA approved facility... these compounding pharmacies can just make the drug and the FDA will look the other way."
Unnamed Contributor [20:03]:
"They specifically put out a letter saying, this is an approved use of the drug."
Marlena [26:39]:
"I didn’t expect it to be so much weird petty drama. And I had wondered if they were profiting off of it."
Sari Sofer Sukanek [33:23]:
"And it sounded like the sheer volume at which she was doing it was exceptional."
This episode of Hyperfixed offers a comprehensive exploration of the complexities surrounding GS441524, highlighting the delicate balance between legal regulation and the persistence of black markets. Through in-depth interviews and listener engagement, Alex Goldman and his team shed light on the multifaceted challenges and triumphs in making lifesaving treatments accessible to feline patients.
For more detailed insights and behind-the-scenes discussions, listeners are encouraged to visit hyperfixedpod.com and join the conversation on their Discord community.