The new Viagra? Rising demand for weight loss medicine Saxenda feeds on illegal online shopping

HealthJune 15, ’22 10:42 pmAuthorErik van den Berg

A growing interest in the weight loss drug Saxenda has triggered a lively online trade in recent months. However, most sites that offer the drug operate outside the bounds of the law, according to research from BNR.

BNR looked at the first twenty online stores that appear in Google when ‘buy saxenda’ is written. Only three of them require a previously waived prescription with an order required by law. An equal number operate on the basis of anonymity and only accept difficult-to-trace means of payment such as cryptocurrencies. However, the online market for Saxenda is dominated by two players who control the rest of the search results through a network of partner sites: the Dutch sites Treated.Com and Dokteronline.com.

Saxenda, a drug called “a game changer” by experts in the fight against obesity, is part of a new generation of weight loss drugs. Compared to previous drugs, the drug is unprecedentedly effective. So effective that in February the National Health Care Institute (Zorginstituut Nederland) announced that it is the first weight loss drug ever to be included in the basic package. This news reached a large part of the many millions of overweight Dutch people through the media. Unfortunately, almost no one was eligible for the drug: only a handful of people in our country meet the medical requirements set by the National Health Care Institute for reimbursement.

Tens of thousands of Dutch people are looking for Saxenda online

Saxenda has been one of the most Googled drugs since February.  For a short period of time, the weight loss drug was even more popular than Viagra, according to Google Trends.
Saxenda has been one of the most Googled drugs since February. For a short period of time, the weight loss drug was even more popular than Viagra, according to Google Trends.

In practice, doctors see that many overweight people who are not eligible therefore start using the drug on their own. ‘From a BMI of 35 with comorbidity or a BMI of over 40, our internist simply prescribes a prescription,’ says internist-endocrinologist Arianne van Bon of Rijnstate Hospital. ‘But we also get a lot of inquiries from people who do not reach the bar.’

Overweight Dutch people have therefore turned to Google en masse in search of Saxenda. Figures from the search giant show that in April there were between 10,000 and 100,000 searches in the Netherlands for ‘buy saxenda’ – the same number as for ‘buy viagra’.

Apotheekonline.net is at the top of the search results for weight loss medicine Saxenda.  It is a partner site for both DokterOnline.com and Treated.com, which is owned by a Dutch internet entrepreneur whose business is registered in Malta.
Apotheekonline.net is at the top of the search results for weight loss medicine Saxenda. It is a partner site for both DokterOnline.com and Treated.com, which is owned by a Dutch internet entrepreneur whose business is registered in Malta.

This explosively growing online demand is now also being met by a growing online supply, which is a thorn in the side of Dutch healthcare providers. The development evokes memories among many experts about the trade in erection pills, which years ago was worth several billion euros. ‘It would not surprise me if it is the next category of drugs that will be traded this way,’ says Ruud Coolen van Brakel, director of the Department of Responsible Use of Medicine. Risky, according to the IVM director. ‘It is not for nothing that these drugs are only available by prescription. They can have dangerous side effects. “

Two main providers dominate the Dutch online market

Treated.com, one of the largest players, is based in the UK. Filling out a questionnaire on this page is sufficient to obtain a prescription for Saxenda from a general practitioner working abroad. It is unclear how the medicine subsequently reaches the customers. In any case, the company states that it does not export to the EU. According to the annual accounts of the parent company Treated.com, the owner, a 42-year-old Briton, left around 1.7 million euros in profit from since last year.

Holland's interest in Saxenda exploded in February, after admission to the basic package was announced and then remained high.
Holland’s interest in Saxenda exploded in February, after admission to the basic package was announced and then remained high.

Saxenda can also be ordered from the Curaçao-based Dokteronline.com by first going to an online consultation with a Romanian GP for 29 euros. This consultation consists of filling out an online form where ‘incorrect’ answers (such as reporting an illness that makes use unwanted) light up red for correction. Sales practices already led to sky-high fines on the spot. BNNVARA is also devoted Rambam in 2016 already a section for Dokteronline. Nevertheless, the site is still active in several European countries. Wouter Mol, a general practitioner born in the province of Groningen, runs the business behind the online store.

Both sides claim to function completely within the bounds of the law, but handing out a prescription online is only allowed under strict conditions. Advertising for prescription drugs is also prohibited, but this work is conveniently outsourced by the sites.

Shady partner sites

Both websites use a so-called affiliate program to attract customers. Affiliate sites can make money by redirecting customers to their online stores. Partners do their best to hide their true identity, but sometimes small mistakes give an idea of ​​who the creators are. For example, a piece of code on the ‘apotheekonline.net’ page reveals the name of an ‘internet publisher’ based in Malta, which in turn is owned by a young Dutch internet entrepreneur.

The first hit in the search for 'Buy Saxenda' comes from an affiliate paid for by Treated.com and DokterOnline.com.  Advertising in this way is prohibited in the Netherlands.
The first hit in the search for ‘Buy Saxenda’ comes from an affiliate paid for by Treated.com and DokterOnline.com. Advertising in this way is prohibited in the Netherlands.

The Supervisor Health and Youth Care Inspectorate (IGJ) knows the places, but says he can not do much for companies established abroad: ‘In principle, our supervision does not extend beyond the borders of the Netherlands’, says spokeswoman Mariël van Dam. But the action against the Curaçao-based Dokteronline.com is also going smoothly. For example, it has since managed to withhold a fine for banned advertising for five years by bringing cases to the Council of State. IGJ therefore hopes that consumers take their own responsibility and do not order medicines online. “These drugs may be counterfeit, contain dangerous contaminants or the wrong dosage of the active ingredient,” says Van Dam.

Growth market that generates billions

Saxenda is just one of the medicines for obesity produced by the Danish company Novo Nordisk. The pharmaceutical company that originally made drugs for diabetes changed course in 2015 when it started selling Saxenda. That measure has not harmed the company. The company expects to raise nearly $ 4 billion by 2025 from its sales. Novo Nordisk’s share price has doubled in the last two years. In the United States, one of the world’s most overweight countries, the company even had to temporarily halt sales of one of its drugs after demand exceeded production capacity.

The emergence of a black market seems to be the dark side of this success. In the coming years, there will be even more effective weight loss products on the market that are even more attractive for online sales. Doctors see an important role for these drugs in the fight against obesity, but hope above all that the government will focus on measures that prevent people from becoming overweight in the first place. ‘Medicine works, but if you’re overweight, you can never really get rid of it,’ says internist-endocrinologist Van Bon. ‘Ultimately, you’ll have to look for solutions in our obesity environment. We live in a fat lazy country. Over there we have to get off. ‘

Comments Treated.com and DokterOnline.com

Both sides claim to operate within the boundaries of European and Dutch law.

Treated.com

‘We do not export medicines to the EU … All medicines sold through our platform have a prescription from a qualified EU doctor. The proposal that this practice is illegal is false and defamatory. “

DoctorOnline.com

‘Dokteronline actually offers an affiliate program. As Dokteronline only facilitates a doctor’s consultation with an independent doctor, there are (and may be!) No advertisements for medicines in general. Affiliates ‘expressions in our program are regularly checked by Dokteronline and, if necessary, corrected and adjusted.’

The ‘red information of wrong answers’ you mentioned has been discussed as a point for improvement. We must and will adjust …. Unfortunately, deliberate fraud can never be completely ruled out. An offline consultation can not guarantee this either. ‘

“All healthcare providers connected to the Dokteronline platform are entitled to provide online care on the basis of both European and national legislation applicable to them.”

Novo Nordisk

»Saxenda is a UR medicine and therefore only available if a doctor sees the patient and writes a prescription, after which the patient picks up the medicine at a pharmacy, at the expense of the Health Insurance Act or at his own expense. We supply our medicine to Dutch wholesalers and hospitals, and we therefore do not trade with [Treated.Com of DokterOnline.com.]†

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