The news: The FDA issued 25 warning letters in June to telehealth providers marketing compounded GLP-1s, citing misleading promotional practices, including claims that products contain the same ingredients as FDA-approved drugs Eli Lilly's tirzepatide and Novo Nordisk's semaglutide. The latest enforcement action follows 30 similar warning letters to telehealth companies issued in March and 50 sent in September.

Why it matters: The FDA crackdown is forcing telehealth players to pursue one of two strategies: secure reseller partnerships with Novo or Lilly, or keep selling compounded versions of these drugs. For those that have aligned with the pharma manufacturers, a key challenge for brands is convincing consumers they aren’t selling the same products as their compounding rivals.

That authentic pharma brand partner distinction will become increasingly important as the FDA expands its crackdown. Along with increased marketing enforcement, the agency is moving to restrict large-scale GLP-1 compounding by removing Lilly and Novo approved ingredients from the bulk substances list.

Large telehealth providers (e.g., Ro, WeightWatchers, and Hims & Hers) that have pivoted from compounded GLP-1s are repositioning as broader obesity care platforms, combining authorized access to branded GLP-1s with coaching, nutrition support, and adherence tools.

Meanwhile, providers such as Noom which offers microdosed GLP-1s continue to sell compounded versions under the FDA exception that still permits personalized dosing.

Implications for telehealth brands: Even if the FDA shuts down GLP-1 compounding, gray-market manufacturers and marketers will persist, blurring the lines between legitimate products and unauthorized alternatives. Partnerships with pharma brands only create value if consumers recognize the difference.

Telehealth brands aligned with Novo and Lilly need to make those relationships and access to FDA-approved medicines a core part of their brand positioning. They’ll also need to adopt the rigorous advertising and compliance standards that govern drugmakers, not the looser rules that characterize most telehealth marketing. Brands that clearly separate themselves from gray-market alternatives will be best positioned for the next wave of FDA scrutiny.

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