48 pointsby randycupertino2 hours ago10 comments
  • pfishermanan hour ago
    FDA regulates the marketing of drugs and medical devices. This is a case of Hims and Hers (and other compounding pharmacies) marketing drugs without having been granted approval.

    There is an abbreviated application for new drug approval (ANDA) pathway meant for generics, but it does not seem like H&H has gone this route. It does require you to open your supply chain up to inspections and to provide evidence that your generic version basically works the same as the brand name.

    In my opinion there two things going on here that I strongly feel are true.

    1. Something is systemically wrong in the US when we are cutting off people’s access to meds, like GLP-1s, which have profound health benefits.

    2. Hims and Hers are also in the wrong. The rules and laws are there for a good reason. It is not just for us to arbitrarily pick and choose when to enforce them.

    • ab_testingan hour ago
      I think the real surprise is that hims was able to sell the drug without approval in the first place. I do not support gatekeeping drugs from generic makers but their supply chain should be inspected just like any body else. The fact that they were able to sell a drug for so long without approval shows that something is really broken in the process.
      • roywiggins36 minutes ago
        It's basically a regulatory arbitrage, see here:

        https://old.reddit.com/r/FamilyMedicine/comments/1nz5xkd/how...

        > they get away with it because:

        > In-house prescription

        > legally registered 503A compounding pharmacy that is not selling bulk (individual prescription quantities)

        > They can argue clinically distrinct compounding

        > FDA does limited enforcement unless its unsafe or mass bulk production

        Point 4 seems not to be holding anymore.

      • 38 minutes ago
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    • lotsofpulpan hour ago
      > The rules and laws are there for a good reason

      Are they? This example seems to be a clear contradiction of your first point. Stuff like this weakens the authority and credibility of the FDA, allowing legitimacy to people like RFK.

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  • elamje16 minutes ago
    The situation is basically this -

    Novo and Lilly spent billions making Semaglutide, Tirzepatide, and future formulations/modalities.

    They are going to monetize this heavily while they have IP coverage. There is no world they will let HIMS or any compounding pharmacy of scale undercut them.

    On the insurance front - expect your insurance to decline this forever unless you are at serious risk of diabetes. It would make you cost them $3-6k/yr more. Insurance premiums would rise for everyone if insurance was subsidizing this - no free lunch.

    Fortunately, the prices are coming down. Amazon pharmacy has Wegovy in an auto-injector starting at $199 without insurance. And that’s delivered to your door in under 24 hrs in most major cities.

    I highly recommend checking out the terms of trumprx.gov - not endorsing the entire government here, but it is actually working and quite cleverly written to ensure Americans are getting the lowest cost drugs in the world now. Historically, we subsidized R&D globally by allowing pharma to make most profits on Americans then have cheaper prices abroad. That is changing and hopefully that’s a net positive.

    • alephnerd14 minutes ago
      The major Indian generics manufacturers have signed branding and IP agreements with Lilly and Novo as well, so the only people that are hurt are consumers I guess.

      India wins (because Indian pharma gets IP and branding transfers). The Trump admin wins (the right strategic lobbying was done). The GOP wins (strategic tariffs on Iowa, North Dakota, and Montana lentil and soybean oil exports were about to kick off in India after they were hit by similar tariffs from China). The consumer (who voted for Trump) loses.

      Welcome to a trade war.

  • cj2 hours ago
    It’s unfortunate that shutting these companies down will result in less people gaining access to the drug.

    GLP-1’s might be the best thing to happen to medicine this decade - I personally want everyone who would benefit from it to have access.

    • lvspiff34 minutes ago
      Was my glucose under control without glp-1's? Yeah I could manage an a1c of 5.4-5.6 with metformin but I was still hovering near 300 lbs.

      With glp-1's I'm down over 50 lbs, my a1c is a much more manageable around 4.0-4.5 and it makes it much easier to exercise and portion control is a huge benefit. Not to mention a buncha other things like triglicerides and blood pressure have come down due to exercise and eating better. it sucks i have to take it forever, but at the same time i feel a ton better physically, and if i loose 50 more lbs, and labs continue to show improvement, i can reduce the cocktail of other meds I'm on my doc says.

      Cigna denied me at first until my doc appealed twice. Cigna wouldnt cover because i wasnt a full diabetic so wasnt on insulin. I would've had to pay close to $1k a month to take it otherwise. Thank goodness for a tenacious doctor!

    • notesinthefield44 minutes ago
      It was infuriating trying to get Wegovy via insurance. My doctor made three appeals, all denied. Out of pocket it wouldve been $1600/mo. Ive been getting semaglutide from compounding pharmacies for the last year and half for $149-$200. I have lost 97lbs, come back to running 30 miles a week after several major knee injuries made even a mile jog a multiday recovery effort. I absolutely get the regulatory stance but the name brands are absolutely unaffordable.
      • AuryGlenz14 minutes ago
        They’re down to hundreds a month, now, with a coupon.

        I can’t say I disagree with insurance not being willing to pay those costs (apart from diabetes patients etc.). I bet a large part of the reason you can get the name brands cheaper now is because they did the math they’d make more that way than they could squeeze out of insurance companies.

        Also, on a personal level it rubs me the wrong way to have my insurance premiums go towards something that people could just do themselves, from something they did to themselves. I know many will disagree, of course, and there are other examples (say, lung cancer treatments) that are similar.

      • bdcravens17 minutes ago
        Do you have diabetes, heart disease, or another condition necessitating a GLP-1?
  • insuranceguru32 minutes ago
    this was bound to happen with the number of compounding pharmacies getting into the glp-1 game. from a risk side, it’s a total mess it’s basically impossible for insurers to model long-term liability when the supply chain for these drugs is a black box. fda had to drop the hammer before the claims started flying.
  • randycupertino2 hours ago
    This is big. HIMS and HERS and other companies are blantatly skirting patent laws under the guise of compounding.
    • krackersan hour ago
      >blantatly skirting patent laws

      Why is this a bad thing? The quickest way to fix the medical/insurance/bureaucracy complex is to just allow people to sell direct to consumer.

      The best (worst) example of this is CPAP. Ideally you'd just be able to go and buy one for $300, but instead there is a complex around "necessity" and "prescription", which creates an effective monopoly where the exact same hardware can be sold at different price points with software locked features.

      If even a "simple" mechanical device like this which violates no patents and can't materially harm a person in any way can be restricted on grounds of paternalistic "safety", then one would be right to remain skeptical of the claim that the FDA is restricting action against unauthorized semaglutide knockoffs to

      >safeguard consumers from drugs for which the FDA cannot verify quality, safety, or efficacy.

      • loegan hour ago
        Why is it bad when companies break the law? We have patent laws for a reason (to incentivize enormously expensive drug development).

        Novo and Lilly already sell direct to the consumer! Yes, you need a prescription, but once you have one you can buy straight from the manufacturer.

        • selectivelyan hour ago
          That's nice. The rest of the world has price caps on what these companies can charge for drugs.

          It's one or the other. You can have your ''patents'' and ''intellectual property'' respected...but that requires you not charge an outrageously higher price in certain markets, like the US.

          • johanvtsan hour ago
            What percentage of global rich, obese people live in the US? This is the main market and the product would not exist if it could not command a high profit here. Besides that, I think the US prices are so high due to the insane medical insurance structure, not because the drug companies really make much more than in other countries.
          • pfdietzan hour ago
            The rest of the world is free riding.

            The solution is a law preventing drug firms from pricing in the US higher than (some small multiple of) what it charges anyone else in the world.

            • Closi39 minutes ago
              > The rest of the world is free riding.

              The rest of the world isn't free riding - the USA has just setup a market where there is very little bargaining power for consumers because of how the US medical market and insurance works.

              Novo and Eli are still making plenty of money in Europe where these drugs cost a fraction of the price, and where there aren't other significant suppliers for GLP-1's like is being implied.

            • johanvtsan hour ago
              Somebody has to pay for the drugs development, the poor can't pay, if the rich (US) won't pay, there simply won't be any drug.
            • selectivelyan hour ago
              Nope.

              That would require those same companies from not abusing our political process to obtain illegal political outcomes - outcomes that are unconstitutional - like Citizens United, which led to PHrMA dumping unimaginable money into bad faith political advertising/lobbying.

              Until or unless they stop being bad actors, everyone should pirate their stuff. Free Luigi.

              • eddythompson80an hour ago
                Whenever someone cites Citizens United, I'm 99.9% sure they have no idea what that ruling was about.
                • selectivelyan hour ago
                  In other words: you are a reactionary who thinks little of others. Noted.
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        • Spivakan hour ago
          As always, depends on the law. This is a bright line example of companies breaking the law to the direct tangible benefit of not only their customers but the population at large. Letting Novo Nordisk jack the price back up and deprive the vast majority of Americans access to the greatest good to public health in a century meanwhile is… maybe not the example you should be holding as the law working.
      • cm2187an hour ago
        Well you either remove all the bureaucracy around drug testing and approval and make it cheap to develop a new drug, or you prevent drug makers from making money if they are successful at developing a new molecule. But if you do both, all you will get is zero research. Right now it takes 10s of billions in R&D budget to bring new molecules to the market, which is insane.
      • an hour ago
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      • dyauspitr19 minutes ago
        As long as the company that did the research and the medical professional gets paid the same amount. I’m completely OK with cutting out the insurance and the bureaucracy and other non-value add middleman, but the value add partners need to get paid for this to be sustainable.

        Patent laws exist for a reason. It’s so people that come up with paradigm changing ideas and inventions can get rich off of it. This is something we want to maintain.

      • SilverElfinan hour ago
        Yep in other countries CPAPs are over the counter. In America you need to go to a sleep lab for a wasteful overnight sleep study (sometimes two!) that costs thousands. And then have appointments with a “doctor” who provides no useful help but is necessary for the prescription. All for the machine to figure out its own optimal settings anyways. Total racket and regulatory capture.
        • krackers39 minutes ago
          Right I used CPAP as an example because it bypasses all arguments about "novel technology", "drug development" cost, or "need for safety". Even an ASV algorithm could probably be implemented as a ~graduate project since it seems to be a rather basic control algorithm (today with ML you could probably do even fancier things). It's basically a piece of pure technology that could be commoditized, manufactured and sold to people for < $300 in the way smartphones are. If something as "basic" as this can't be accomplished due to the regulatory environment then it's sort of pointless talking about anything more complex like pharma drugs.
    • hn_throwaway_99an hour ago
      > blantatly skirting patent laws

      Can you please explain (TFA doesn't mention patent laws, just unregulated drugs)? For example, my understanding is that semaglutide is protected by patent in the US - I had assumed HIMS was including semaglutide in some of their formulations under an agreement with the patent holder, but I guess that's not correct?

      Side note, I'm all for the true innovators being able to patent drugs (like semaglutide) that they put a lot of research dollars into, but seriously fuck all these additional "method of delivery" and "formulation" patents that are bullshit that just get added on later by the patent holder solely as a way to try to restrict the entry of generics into the market after the original patent expires.

    • raincoman hour ago
      Everyone can make their own compounding drug in their basements, thanks to Telegram and other hidden platforms: source sema/tirz, get bac water, mix them.
    • teaearlgraycold2 hours ago
      I’m generally happy to see IP disrespected.
      • AuryGlenz13 minutes ago
        Then you’ll eventually be generally unhappy to see no new medications come out.
    • mullingitoveran hour ago
      > blantatly skirting patent laws

      Implied but not explicitly stated in the FDA announcement: the compounders’ real crime is not paying their protection money.

    • J7jKW2AAsgXhWm2 hours ago
      Mochi health too
  • throw31977an hour ago
    As an aside, I wonder why this wasn't discussed during the recent Greenland dispute. The US government basically legally pirate the drug, and it'd make a fairly large dent in Denmark's economy. It'd be a politically popular move too.

    https://en.wikipedia.org/wiki/Government_patent_use_(United_...

    • Retrican hour ago
      The responds of Denmark and or worse the EU invalidating US patents in retaliation is rather dangerous.
      • throw31977an hour ago
        Sure, but not as dangerous as a literal military showdown which was also on the table.
  • SilverElfinan hour ago
    Given how transactional this administration is, you can be confident that one set of companies donated to the administration or enriched the Trump family somehow, and the other set is facing regulatory attacks.
  • alephnerd36 minutes ago
    And India wins again!

    There's a reason the major Indian generics manufacturers like Cipla have partnered with Ely Lilly [0] and Novo Nordisk [1] for exclusivity deals for GLP branding and IP even though it isn't required outside the US.

    Keep screeching about H1Bs and offshoring while sweetheart deals are signed with the Trump admin [2] by lobbyng with the right leverage points [3][4][5][6] and threatening the right GOP ruled states with tariffs [7][8].

    Thanks to Trump, India has finally began reversing the brain drain, and with it bringing Big Tech [9], Big Pharma (already mentioned), Big Oil [10], and Wall Street [11] back.

    [0] - https://www.reuters.com/business/healthcare-pharmaceuticals/...

    [1] - https://www.reuters.com/business/healthcare-pharmaceuticals/...

    [2] - https://www.whitehouse.gov/briefings-statements/2026/02/unit...

    [3] - https://www.trump.com/residential-real-estate-portfolio/trum...

    [4] - https://www.trump.com/residential-real-estate-portfolio/trum...

    [5] - https://www.trump.com/residential-real-estate-portfolio/trum...

    [6] - https://www.trump.com/residential-real-estate-portfolio/trum...

    [7] - https://www.daines.senate.gov/2026/01/20/daines-travels-to-i...

    [8] - https://governor.iowa.gov/press-release/2025-09-16/gov-reyno...

    [9] - https://www.bloomberg.com/news/articles/2025-12-11/india-dra...

    [10] - https://www.wsj.com/business/energy-oil/big-oil-is-offshorin...

    [11] - https://www.bloomberg.com/news/features/2025-11-11/trump-s-h...

  • mindslight2 hours ago
    Is there a cash price for getting the government to shake down your competitors, the way there is for pardons ? Or is this type of service only available in exchange for equity stakes?
  • tptacekan hour ago
    It is wild that it took until 2026 for this to happen.

    In the late 1990s, when my friends wanted mushrooms or 5MEO-DMT, they'd order from "Poisonous Non-Consumables" catalogs. Today, people are literally doing that (same words, even!), but for the next iteration of GLP1 drugs not yet on the wider market. Compounding pharmacies are selling "research chemicals", like in Bitcoin Mining Profit Calculator: Gaiden.

    • loegan hour ago
      I think this is compounding pharmacies selling legit semaglutide (or tirzepatide?), but doing the packaging (dilution in water) themselves. No? I don't think Hims is selling RCs. They're violating Novo's (or Lilly's) patents.

      It is wild to me that compounding pharmacies continued to sell these in violation of patents even after the expiration of the FDA supply shortfall status last year -- but I suppose there's so much money in it they don't want to give it up.

      https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...

    • cjan hour ago
      People are getting retatrutide from random websites (not what’s being shut down here) not from compounding pharmacies.
      • tptacekan hour ago
        Totally fair point. I'm just surprised how poorly regulated this stuff is.
        • loegan hour ago
          The regulation is pretty clear? We just don't choose to blackhole shady foreign companies from the American internet as a matter of policy. And cannot effectively screen all imports.