[yold__]

Semaglutide / GLP-1 compounding is not limited to just Hims. Lot's of pharmacies do it. The manufacturer (Novo Nordisk) charges 5x-10x for the exact same thing. The author calls the GLP-1s used in compounding "Chinese Knockoffs", but offers no evidence of quality control problems, and is instead relying on the reader's prejudices.

GLP-1 drugs may be a game-changer for obesity and diabetes, the same way that cholesterol (statin) drugs have greatly improved heart health. Hopefully reversing a long trend of increasing waistbands in developed / developing countries. Unfortunately, America will pay the highest price (including Medicare). I'm all for anything that makes them cheaper, including the many compounding pharmacies currently exploiting the loophole the author takes issue with.

[827a]

Agreed. The number of times the article specifically calls out "shady Chinese knockoffs" is honestly, actually, racism. If there's evidence that Hims' drugs are harmful: Present it. The article doesn't. I know tons of people who have used Hims and companies like it, for a variety of things. I'm aware of no specific or general problems anyone has had with their medication.

[selfhoster11]

China provably has seen issues with adulteration of food: https://en.wikipedia.org/wiki/2008_Chinese_milk_scandal

That is not to say that Hims's drugs were unsafe, or that they even came from China to begin with. What I am saying, is that it's not racism to mention that Chinese products are, in fact, occasionally shady (of poor quality).

[827a]

Sure; and a bunch of Phillips (a European company) CPAP machines (which had received full FDA clearance) killed over 500 people [1]. The J&J COVID vaccine gave over 100 people GBS [2]. We could go back to the 80s and pick on the Therac-25, which caused six incidents of severe radiation exposure or death [3]. And a thousand other examples in-between, of western made, FDA approved, vetted, and tested medicines or therapies that ended up killing people.

It would be stupid to believe that the FDA doesn't serve an important purpose. But, it would be equally daft to believe that even FDA-cleared products aren't, in fact, occasionally shady (of poor quality). It would be racist to believe that China is unique in the production of occasionally shady products; that the same things don't happen all the time in western manufacturing facilities.

[1] https://www.fda.gov/medical-devices/recalled-philips-ventila...

[2] https://www.yalemedicine.org/news/covid-vaccine-guillain-bar...

[3] https://en.wikipedia.org/wiki/Therac-25

[throw10920]

> The number of times the article specifically calls out "shady Chinese knockoffs" is honestly, actually, racism.

Factually incorrect. A country is not a race. You cannot be racist against a country, by definition, and China in particular has a very well-documented pattern of making low-quality clones of products from other countries (often using IP stolen from those countries), so the concern is well-justified.

More generally, the use of "racism" as a response to well-justified concerns about products of a country is completely irredeemable. It's logically invalid, emotionally manipulative, breaks the HN guidelines, is blatantly anti-intellectual, and is mostly used as a propaganda technique by state actors. Please keep this drivel off of platforms like HN that are designed for intellectual curiosity.

[eurleif]

It's interesting to consider why criticisms of China in particular are often interpreted as racism. No one makes the same accusation if you criticize America. Part of the explanation may be that China is much more ethnically homogenous: Han Chinese are 92% of the population. It seems that in the name of opposing racism, people are effectively rewarding China for being an ethnostate.

[throw10920]

> It seems that in the name of opposing racism, people are effectively rewarding China for being an ethnostate.

My understanding of criticism of China (in particular - although I have also seen this effect with many other countries) being interpreted as racism is very different than the explanation that you provided, but that's too long to get into. Meanwhile, this is an extremely interesting second-order effect that you pointed out that I hadn't realized before. Thank you for pointing this out!

[selfhoster11]

> It's interesting to consider why criticisms of China in particular are often interpreted as racism.

Astroturfing of the criticism of China = racism view is presumably a part of it. I don't consider investigating bot account networks to be a hobby of mine, so no, I don't think it's "interesting to consider."

[827a]

Typically I would agree on the separation of nationality and race; but in the case of China its actually far more accurate to intrinsically tie the country and the race, given that this is the official position of the CCP.

[throw10920]

No, it's factually not more accurate. The CCP's policies do not dictate reality, and the morally objectional ethnostate policy is both not actually the reality within China (given that about 9% of the population is not Han Chinese), and is not practiced by the majority of other nations/states in the world.

Most importantly, the author of the article is not based in China, or in any other nation that has an ethnostate policy, but in the US[1]. Therefore, even if you could make the argument that every person in China believes that states = races (which is clearly false), it still wouldn't apply to the author. Or, you know, almost anyone else on Hacker News.

So no, claiming that attacks on China are "racist" is still factually incorrect, and I really would hope that you'd invest the bare minimum of effort to verify that your claim is correct before throwing such an extreme accusation at someone.

[1] https://www.alexkesin.com/p/who-is-alex-kesin

[kridsdale1]

Truthfully China is the source for a huge amount of “legitimate” generic and brand name patent protected drugs.

China produces things. Of high quality as well as low. More and more, it’s the only source for high quality things.

The OP’s conniption is about intellectual property and monopoly protection, not health.

Everyone in the world (almost) would be far healthier with weekly injections of Chinese chemicals.

[beejiu]

Isn't the point of regulation to set the bar you must prove you meet, rather than a bar you must prove others haven't met?

[atombender]

There are concerns around safety. Compounding is somewhat controversial because they produce versions of FDA-approved drugs that are not FDA-approved, and may use chemical formulations (such as semaglutide salts) that aren't FDA-approved. [1]

The problem isn't that compounding pharmacies provide cheap versions of the same drug, it's that the compounding process doesn't produce exactly the same drug, and hasn't undergone the same stringent quality controls as Wegovy etc.

Ideally, these drugs should be cheap. The compounding is only done because there's a loophole that provides a market opportunity. The correct solution would be to improve the regulations in a way that would let more manufacturers produce safe generics.

[1] https://www.goodrx.com/classes/glp-1-agonists/compounded-sem...

[Spooky23]

The problem with your position is simple: where does it come from?

The legit path for compounded semaglutide is buying up Rybelsus, impacting the supply for diabetics. Compounding pharmacies are notoriously shady, and are likely using grey market materials from questionable sources.

[bevr1337]

> Compounding pharmacies are notoriously shady, and are likely using grey market materials from questionable sources.

Are they? Compounding pharmacies are common and boring. If someone hasn't yet used a compounding pharmacy then it's likely they're in very good health -- yay for them!

What's being described doesn't feel like an issue with compounding rather folks setting up shop to peddle questionable drugs.

[bickfordb]

Is there evidence that compounded Semaglutide from Hims pharmacies has harmed anyone?

[hammock]

Safe and effective. Side effects are very rare and are usually limited to soreness at the site of injection. Recommend everyone who is recommended semaglutide by a relevant authority, to get it. The obesity epidemic is a national security concern

[zdragnar]

I don't think the question was whether semaglutide was safe, but whether the version that Hims sells is safe. That includes things like being free from contaminants, stability of the compound, etc.

[Spooky23]

Hims just outsources fulfillment to a compounding pharmacy. Usually they add vitamin B-12 to make it "customized". Are they crushing rybelsus? Getting raw materials through some mysterious supply chain from Ukraine, China or Israel?

You have no idea.

On the flip, I think access to basic drugs for stuff like ED, hair loss, etc is fine. But they also do stuff like off-label anti-depressants, etc can potentially be dangerous... but at the same time, people are going to urgent cares and getting antidepressants with just more cost and friction.

[ryandrake]

> I don't think the question was whether semaglutide was safe, but whether the version that Hims sells is safe.

Don’t forget “effective” too. If you just make the bar “safety” then you are accepting sugar pills as medicine for whatever condition. You should need to prove both safety AND effectiveness.

[hammock]

Sugar is arguably more “effective” than it is “safe.” But I know you are referring to sugar pills not sugar diet

[hammock]

How would you even test for that?

[Der_Einzige]

Yup. And using it as the wonder drug it is, I.e women using it to get “beach bodies” should be celebrated and not stigmatized.

I want bodily autonomy and control. The right to experiment with weight loss drugs is analogous to the right to be trans or to not have your foreskin removed at birth.

It’s crazy that these drugs even have further benefits like anti addiction properties!

[DrillShopper]

> The right to experiment with weight loss drugs is analogous to the right to be trans or to not have your foreskin removed at birth

Both things the current administration is fighting against, so the metaphor is really apt.

There are a lot of trans people on HRT that DIY their meds, especially transfemmes, because estrogen is not a controlled substance.

[hammock]

Miracle drugs. I wouldn’t be mad if we made these injections required for entry into public schools or employment

[bitwize]

Semaglutide is linked to NAION, a "stroke" in the retinal blood vessels linked to a blood pressure drop there, typically when sleeping. I think I already have one of these in one eye. I DO NOT want to risk getting it in the other. Staying off semaglutide until it's really necessary.

[sizzle]

That’s a pretty bold claim, got a citation to back it up?

[bitwize]

https://pubmed.ncbi.nlm.nih.gov/38958939/

[jrflowers]

Can you give some specific examples of compounding pharmacies buying up Rybelsus or using grey market GLP-1

[Spooky23]

There’s a bunch of material out there including acknowledgment from the association of compounding pharmacies.

They are in general shady, and the Florida pharmacies are notoriously under-regulated. Guess where most of the online dick pill outlets do their compounding?

[Brian_K_White]

Why would this product be different from any other product?