These days, references to Ozempic are all over. Ads for the diabetes-management-turned-off-label-weight-loss drug have jumped from TV to out-of-home, blanketing the New York City subway. Ozempic, having made the rounds in Hollywood, graces the cover of magazines and turns up in comic monologues and organic social media posts. 

Despite its omnipresence in American advertising and culture, securing access to the drug is another matter. Off-label use of Ozempic for weight loss exacerbated a supply crunch, manufacturer Novo Nordisk said. The company has addressed the shortage, although the Food and Drug Administration and Novo say some dosages aren’t back in full

Despite the supply constraints, new prescriptions for Ozempic are up 98% year-on-year, according to J.P. Morgan. And that’s where telehealth companies come in.

Capitalizing on the drug’s weight-loss renown, virtual care firms are writing prescriptions for Ozempic and similar products. Take Ro, the company behind the subway campaign. Ro offers Novo’s Wegovy, which contains the same active ingredient (semaglutide) but is approved for obesity, to patients online.

While PlushCareCalibrate and a number of similarly small telemedicine outfits offer a way to ease access woes, an even bigger player has thrown its hat into the ring. In March, WeightWatchers acquired Sequence, a digital health platform for weight management, for $106 million. A subscription service with about 24,000 members, Sequence offers virtual visits with doctors who can prescribe the drugs.

That gets to another bottleneck such firms are attempting to relieve: access to physicians. Sequence not only has a network of physicians who will write prescriptions; it also helps patients deal with insurers and secure necessary lab results via its ties with LabCorp and Quest. Patients fill out a form, their eligibility is reviewed virtually in as little as 24 hours, and the company delivers the medicine to the patient’s doorstep.

The Sequence acquisition — and WeightWatchers’ calculated entry into the hot market for GLP-1 drugs — speaks to the “gold-rush aura” that surrounds these new medicines, as one analyst put it. This stems from their profound weight loss effects (15% to 18% of body weight for Wegovy); the growing global prevalence of obesity; and the constant searching among diet-obsessed consumers.

Sequence may not be first to the party (weight-loss app Noom quietly started offering writing scripts for the drug as well), but the involvement of WeightWatchers raises the stakes. The 60-year-old brand has a global presence, 3.5 million subscribers and inroads with more than 500 employers and payers (notably including New York City and the Cleveland Clinic). The move certainly gave Wall Street something to cheer about, with WW’s stock soaring after the deal. 

In essence, Novo and Eli Lilly, maker of Mounjaro (tirzepatide), are “getting the services of a large contract sales organization, for free… except it is aimed at the end-user,” Wolfe Research analyst Tim Anderson observed in a research note. The same holds in the U.K., where Boots, the pharmacy chain owned by Walgreens, will soon begin offering Wegovy through its online doctor network.

Yet as much as the two drugmakers stand to benefit from this mad dash, both companies are likely to distance themselves from it, Anderson predicted. No pharma company wants to run afoul of the FDA’s regulatory oversight with respect to off-label marketing. 

WeightWatchers will begin to offer GLP-1s and other medicines for weight loss, along with its standard services, and that won’t just include drugs formally approved for obesity, like Wegovy. It will also include medicines such as Mounjaro, which is only approved for diabetes at the moment but which has been found to help patients shed as much as 20% or more of their body weight. 

Sequence is both promoting and prescribing Mounjaro for this use already, advertising the drug on its website as a weight-loss medicine. About 33% of scripts for it thus far are thought to be for non-Type 2 diabetes patients, although across the GLP-1 brands the rate is probably closer to 10%-15%. 

In addition to the headaches posed by marketing off-label use, drugmakers have other reasons to proceed with caution. While virtual care companies say they only offer medications to qualifying patients (those with a body-mass index that meets the obesity threshold of 30), some telehealth outfits are aggressively advertising on social media, marketing it to people who aren’t actually overweight. 

One such firm, Next Medical, was found to have been running fake before-and-after photos of people who were said to have slimmed down. After inquiries from The Wall Street Journal, the tech startup halted the testimonials, as well as a set of TV commercials that may not have featured actual patients.

As they seek to cash in on demand, these telehealth companies could see a sizable windfall. Based on a survey of endocrinologists, J.P. Morgan expects about a third of obesity patients will stay on weight-loss drugs chronically, with another 50% remaining until weight loss plateaus and then either discontinuing or using therapies intermittently. 

The investment bank forecasts tirzepatide gaining “significant share” over the next seven years and Wegovy use substantially increasing in the next year as earlier supply hitches (which disrupted the initial launch last year) improves. But WeightWatchers’ entry could mark a turning point. 

The iconic company, which has offered weight loss and fitness along with dietary management on a subscription basis for years, is pivoting its business model. In the process, it’s effectively becoming “a free sales force” for Wegovy and for Lilly’s tirzepatide in obesity, Anderson noted. That adds heft to what is currently “a cottage industry of telemedicine obesity care providers.”