Planet Money — "Buy discount Ozempic here now click this link"

Date: August 22, 2025
Host: Jeff Guo
Co-Host/Correspondent: Sydney Lupkin
Featured Guests: Phil (Chemistry Teacher and Patient), Marta Waszynska (Brookings Institution), Chris Spears (Telehealth Entrepreneur)

Episode Overview

This episode dives deep into how the explosive demand for Ozempic and similar weight loss/diabetes drugs has upended normal pharmaceutical markets in the U.S., spawning a parallel, loosely regulated system of supply using compounding pharmacies, direct-to-patient imports, and telehealth startups. Through the personal story of Phil, a chemistry teacher whose life was changed by Ozempic, the show explores how a confluence of high prices, drug shortages, patent protections, and consumer desperation created fertile ground for a “wild west” in weight-loss drug acquisition.

Key Discussion Points & Insights

1. The Transformational Impact of Ozempic

• Phil’s Journey with Addiction (00:49–03:58):
  • Phil, a chemistry teacher, recounts decades-long struggles with opioid and alcohol addiction. After being put on Ozempic for prediabetes, he found not only his weight dropping, but his cravings for food, pills, and alcohol disappeared too.
  • Quote:

    “The craziest thing that I can describe is what it [Ozempic] does is limit the rewards, like all those—the food, the pills, and the alcohol—it quiets all that noise…” — Phil (02:41)

  • Ozempic enabled Phil to reclaim the life he wanted, be there for his family, and shed unhealthy coping mechanisms.

2. The Financial Barrier and Break in Supply (04:01–04:56)

• For a year, Phil’s insurance made Ozempic affordable at $25/month. When his insurance switched, the price soared to over $1,000/month, putting his recovery and health at risk.
  • Quote:

    “And I kind of have to be on this drug. It’s not optional for me.” — Phil (04:35)

• Phil joins millions of Americans caught between high list prices and supply shortages.

3. How Drug Markets Normally Work—And How This One Broke (08:08–11:07)

• Exclusive patent protection: Companies like Eli Lilly and Novo Nordisk enjoy monopolies for years, setting prices high to recoup development investment.
• Normally, generics bring prices down after patents expire. Here, demand exploded long before patents ended, and drugmakers couldn’t ramp up production fast enough.
• Insight from economist Marta Waszynska (09:47):

  “Holy smoke, this is different… How can they get away with this?”

4. Compounding Pharmacies and the "Copycat" Boom (12:05–17:03)

• FDA shortage declaration loophole (12:05): When the FDA declares a shortage, compounding pharmacies can legally make “copies” of the drug, even if it's still patented, bypassing usual approval processes.
• Compounding ramps up to fill the void but inhabits a regulatory gray zone.
• Active ingredient supply flood (17:25): As U.S. demand outpaced domestic supply, Chinese factories rushed to produce the semaglutide powder for compounders—enough to supply “1.2 billion starting doses” in only eighteen months. (18:13–19:25)

5. Telehealth Companies: A New Middleman (15:39–17:03)

• Entrepreneurs like Chris Spears founded telehealth companies to further streamline access—connecting patients with prescribing doctors and pharmacies, operating outside the traditional insurance model.
• Business exploded:
  • 14 customers in January 2024 → 50,000/month within a year.
  • Over 1,000 telehealth competitors now exist.

6. New Dangers, New Risks, and Market Chaos (19:25–21:50)

• Compounded drugs sidestep standard FDA approval and quality controls:
  • Ingredient sources (mainly in China) are only minimally regulated.
  • “This sounds like a total Wild west… or Wild east, given where the product is coming from.” — (20:35)
• State oversight is patchy; quality, potency, and safety are inconsistent.
• Some scam operators are active; compounded drugs were always meant to be temporary.

7. The "Shortage is Over"… Or Is It? (24:08–27:21)

• FDA ends shortage declarations in late 2024:
  • In theory, compounding pharmacies should halt non-custom production.
  • Some compounders sue the FDA, arguing true demand is obscured by non-traditional channels.
• Attempted workarounds: adding vitamins, making patches, or creating actual custom mixes by tailoring ingredient combos to individual patients.
  • Quote, Chris Spears on new compounding model:

    “The doctor’s looking at blood work, looking at your gut biome testing, looking at your DNA and then saying, this is the right set of additives for you to have the best outcome.” (27:03)

8. The Big Pharma Response (28:00–28:48)

• Brand manufacturers, feeling price pressure, offer new discounts for out-of-pocket buyers—e.g., Wegovy for $500/month direct from Novo Nordisk (previously >$1,000/month).
• Novo Nordisk tells investors that compounded versions are eating into their sales.
  • “It’s like trying to put a genie back in the bottle.” — Marta Waszynska (28:40)

9. The Final Disruption: Patients Go Full DIY (29:36–33:14)

• Some, like Phil, bypass even the compounders and telehealth companies, buying the raw powder direct from China or India via networks found on Reddit and Discord.
  • Phil shows how he mixes and injects his own DIY Mounjaro for $50/month—1/20th retail price—despite safety concerns.
  • Quote, Phil:

    “You guys are focused on the risk and I get that, but I’m focused on a drug that I have to have in my life.” (33:02)

• Labs, purity, and safety are crowdsourced; listeners are warned about the risks, but desperation—driven by cost and lack of trust in pharma—overrides.
  • Quote:

    “I don’t trust pharmaceutical companies very much. I mean, I don’t trust them at all. Look what they’ve given us with OxyContin.” — Phil (32:06)

Notable Quotes & Memorable Moments

• Addiction and Ozempic's strange side effect:

  “All my comforts, you know…were no longer there… my wife called me Emotional Phil, Ozempic Phil..." — Phil (03:26)

• Supply chain whiplash:

  “So I know a bit about the topic…Holy smoke, this is different.” — Marta Waszynska (09:47)

• Magnitude of active ingredient imports:

  “Looking at a period of about a year and a half, Marta counted enough semaglutide to make 1.2 billion starting doses.” — Sydney Lupkin (19:13)

• Regulatory chaos:

  “This sounds like a total Wild west… or as we might want to say here, Wild east...” — Marta Waszynska (20:35)

• Consumer desperation:

  “You guys are focused on the risk and I get that, but I’m focused on a drug that I have to have…” — Phil (33:02)

Important Timestamps

• 00:49–03:49 — Phil’s addiction story and Ozempic’s impact
• 04:12–04:56 — Insurance loss leads to $1,000+ monthly Ozempic price
• 12:05–13:49 — Compounding pharmacies ramp up "emergency" supply loophole
• 15:39–16:32 — Chris Spears’s telehealth business takes off
• 17:25–19:25 — Chinese bulk ingredient surge; “1.2 billion starting doses”
• 20:35 — "Wild west/East" of compounding pharmacy oversight
• 24:08–27:21 — Post-shortage compounding, legal skirmishes, custom blends
• 28:00–28:48 — Big Pharma offers discounts and acknowledges market erosion
• 29:36–32:06 — Phil goes DIY: ordering, mixing, injecting his own drugs
• 33:02 — Phil: “I have to have [this drug] in my life”

Episode Tone & Language

The language is empathetic, candid, and often colloquial—mirroring the complex emotions of those dependent on these medications, but also highlighting the absurd (and sometimes risky) “Wild West” nature of the current marketplace. There’s a sense of amazement at the speed of the market’s evolution and a sharp critique of regulatory and corporate failures. Phil’s desperate pragmatism, Chris Spears’s entrepreneurial improvisation, and Marta Waszynska’s wonkish disbelief set the tone.

Takeaway

The unprecedented boom in demand for drugs like Ozempic, combined with pharmaceutical monopolies, regulatory gaps, and the digital marketplace, has created a rapidly growing, chaotic gray market. Patients, doctors, entrepreneurs, and regulators are now improvising in real time, with consequences for drug safety, access, and the future of how high-demand medications are distributed in the U.S.—a case study in unmet needs, market failure, and consumer ingenuity.