Physicians and researchers are raising alarms about a category of direct-to-consumer telehealth websites that prescribe medications — including GLP-1 weight-loss drugs, ketamine, and erectile-dysfunction treatments — after brief online questionnaires, often with little or no follow-up care, according to clinicians, legal experts, and a recent peer-reviewed study.
Telehealth websites prescribe drugs with minimal screening, drawing concern from physicians and researchers
Physicians and researchers are raising alarms about a category of direct-to-consumer telehealth websites that prescribe medications — including GLP-1 weight-loss drugs, ketamine, and erectile-dysfunction treatments — after brief online questionnaires, often with little or no follow-up care, according to clinicians, legal experts, and a recent peer-reviewed study.
Chad Wittekind, a Columbus, Ohio-based primary care provider who works in geriatrics, said he spent weeks trying to diagnose a patient whose blood pressure was dropping before learning the patient had obtained an erectile-dysfunction medication through a telehealth website without disclosing it. Wittekind said he has also seen a patient receive ketamine tablets through a telehealth site and another receive a GLP-1 weight-loss drug despite having a body mass index of 18.7, which he said should have disqualified the patient under U.S. Food and Drug Administration guidelines.
Hundreds or potentially thousands of such sites have proliferated in recent years, according to Rebecca Gwilt, managing partner of Elevare Law, which consults with digital health care companies. Gwilt said the model requires an entrepreneur only to build a website and market services, with outside companies providing the infrastructure to connect patients with contracted physicians and partner pharmacies. The sites typically accept credit cards, do not take insurance, and allow a medical provider to review a patient's self-reported health history and issue a prescription — sometimes on a recurring basis — within minutes to hours.
The U.S. telehealth market was estimated at $28.3 billion in 2025, according to Grand View Research, and is projected to reach $60.4 billion by 2033. Venture capitalists and private equity groups have invested millions in telehealth startups, some of which have only a few employees, according to the article. Elliot Tabibian, who said he launched his first telehealth site at age 18 and now operates two sites at age 22, said he entered the field after learning a friend paid $200 for a 30-second phone appointment and received a medical marijuana card. One of his current sites offers medical exemptions for car window tinting.
The growth of direct-to-consumer telehealth accelerated during the COVID-19 pandemic, when insurers loosened restrictions to expand access to care. When GLP-1 drugs debuted in 2021 and went into shortage, telehealth entrepreneurs partnered with compounding pharmacies — which mix active ingredients at lower cost than brand-name manufacturers — to meet demand, Gwilt said. Dr. Anjali Deshmukh, a pediatrician and health law professor at Seton Hall University, said the sites exploited gaps created by expensive, inconvenient traditional care: 'They did not create the problem, but they are unquestionably profiting.'
A July 2026 study published in JAMA, in which a researcher attempted to obtain prescriptions from 49 telehealth websites, found 'limited clinician engagement' and documented prescriptions issued despite patients not uploading required photos or meeting other site requirements. The study also found that the same clinician sometimes provided multiple different prescriptions for the same patient across several sites. Dr. Reshma Ramachandran, a Yale professor and clinician and one of the study's authors, said some sites made unsubstantiated efficacy claims about compounded GLP-1s and did not disclose that the drugs were compounded.
A Senate investigation into a handful of telehealth sites found that 85% to 100% of patients who interacted with a provider received prescriptions, according to the article. Lawsuits have been filed alleging inadequate care related to at-home ketamine, Adderall, and hair-loss drugs, and in a few cases patients have died after receiving what their families allege were inadequate telehealth services. Some suits also allege that telehealth sites pressured doctors to prioritize profit over patient health.
Experts quoted in the article said few laws currently regulate these sites, which can characterize themselves as platforms connecting patients with independent providers. The FDA is weighing a committee recommendation, issued during a two-day July hearing, to allow specialty pharmacies to dispense six peptides; experts said finalized approval could further drive patients to telehealth sites for those compounds.
- The source does not state which specific telehealth sites were examined in the JAMA study or name the Senate investigation's report.
- The source does not state the total number of patients harmed or the number of lawsuits filed against telehealth companies.
- The source does not provide a response or comment from any telehealth company or its representatives regarding the allegations of inadequate care or improper prescribing.
- The source does not state whether any regulatory agency has taken enforcement action against any of the telehealth sites described.
- The source does not state the current status of the FDA committee's recommendation regarding the six peptides, including when a final decision is expected.
- The source does not state how CareValidate's 20% month-over-month growth figure was calculated or over what time period it was measured.