Austin, Texas – The buzz at South by Southwest (SXSW) this year extended beyond the music, film, and tech spheres, landing squarely in the rapidly evolving landscape of weight loss medications. A pointed exchange between Mark Cuban, co-founder of Cost Plus Drugs, and Linda Yaccarino, CEO of eMed Population Health, highlighted growing concerns about marketing practices and patient care within the direct-to-consumer (DTC) weight loss drug market. Their comments, made during a panel discussion at the festival, underscored a fundamental difference in approach between companies prioritizing affordability and medical oversight versus those perceived as primarily focused on customer acquisition.
The conversation centered on the increasing accessibility of glucagon-like peptide-1 (GLP-1) medications, initially developed for managing type 2 diabetes, but now widely used for weight loss. The demand for these drugs, including Ozempic and Wegovy, has surged, leading to shortages and a proliferation of compounded versions, raising questions about safety, and efficacy. Cuban and Yaccarino’s remarks suggest a critical assessment of how some companies are capitalizing on this demand, potentially at the expense of patient well-being. This debate arrives as SXSW 2026, running from March 12-18, compresses its traditionally nine-day event into a seven-day festival, scattering events across Austin due to the closure of the Austin Convention Center for redevelopment and expansion.
The Critique of “Marketing Companies”
Yaccarino directly criticized certain competitors, alluding to companies beginning with the letters “R” and “H” – widely understood to be references to Ro and Hims & Hers, respectively – alleging a high churn rate of over 50% or even 60%. She attributed this to a lack of adequate medical supervision. Cuban interjected, bluntly stating these companies are “mostly marketing companies.” This assessment aligns with concerns raised about aggressive advertising tactics and potentially insufficient medical screening within the DTC weight loss sector. Hims & Hers, for example, ran a Super Bowl ad in 2025 promoting its weight loss medications, and Ro followed suit in 2026 with an ad featuring Serena Williams, emphasizing FDA-approved GLP-1 drugs. The Serena Williams ad explicitly mentioned FDA approval, a point of differentiation as compounded GLP-1s operate outside of the agency’s direct oversight.
The core of Yaccarino’s argument rests on the importance of ongoing patient engagement and accountability. EMed, she explained, requires weekly check-ins – taking less than 60 seconds – utilizing facial recognition and weight tracking to monitor patient progress and dosage. This contrasts sharply with the alleged practices of competitors, where a lack of consistent monitoring may contribute to higher churn rates and potentially compromise patient safety. Research supports the need for continued monitoring, as individuals often regain weight when discontinuing GLP-1 medications. A study published by TCTMD found that a significant portion of weight loss is regained within 18 months of stopping GLP-1 drugs, highlighting the importance of adherence and long-term support.
Cost Plus Drugs and eMed: A Collaborative Approach
The exchange between Cuban and Yaccarino took place against the backdrop of a newly announced collaboration between their companies. EMed’s employer-based customers will now have access to GLP-1 medications fulfilled by Cost Plus Drugs, known for its commitment to transparent pricing. This partnership aims to address the significant cost barrier associated with these medications, making them more accessible to a wider population. Yaccarino emphasized that both companies share a common goal: “fighting for the lowest price possible to secure the right medications to as many people as possible at the cheapest price.”
Miami-based eMed provides at-home blood collection and GLP-1 weight loss programs, focusing on a comprehensive approach to patient care. This model differs from the more transactional approach often associated with DTC companies. The collaboration with Cost Plus Drugs, founded by Cuban, leverages the latter’s ability to offer medications at significantly lower prices by cutting out intermediaries and negotiating directly with manufacturers. This strategy is particularly relevant given the financial strain GLP-1s can place on individuals and healthcare systems. The high cost of these medications has prompted interventions at the national level, including efforts by former President Trump to negotiate lower prices for Medicare beneficiaries and uninsured Americans through his TrumpRx drug coupon program. Details of the TrumpRx program were announced in November 2025.
Shifting Alliances and the Novo Nordisk-Hims & Hers Agreement
The dynamics within the GLP-1 market are rapidly evolving, as evidenced by a recent turn of events involving Novo Nordisk and Hims & Hers. Just last week, Novo Nordisk dropped its February 2026 lawsuit against Hims & Hers regarding the sale of GLP-1 medications. This legal battle stemmed from a previous collaboration that Novo Nordisk withdrew from in June 2025. The resolution now sees Hims & Hers authorized to sell Novo’s Ozempic and Wegovy products on its platform, while simultaneously ceasing the marketing of compounded GLP-1 medications. The agreement between Novo Nordisk and Hims & Hers signals a strategic shift, acknowledging the value of Hims & Hers’ existing customer base despite previous legal disputes.
This development appears to contradict, at least partially, Yaccarino’s characterization of companies with high churn rates. Novo Nordisk’s willingness to partner with Hims & Hers suggests a recognition of the platform’s reach and potential, even if it doesn’t align with a model prioritizing intensive medical supervision. The situation highlights the complex interplay between pharmaceutical companies, DTC platforms, and the evolving demand for weight loss medications.
The Risks of Compounded GLP-1s
The surge in demand for GLP-1s has fueled a parallel market for compounded versions, created by pharmacies mixing ingredients to replicate the branded drugs. While offering potential cost savings, compounded GLP-1s have raised significant safety concerns. These medications are not subject to the same rigorous FDA oversight as their branded counterparts, leading to variability in quality and potential contamination. Physicians have voiced concerns about the safety of compounded GLP-1s, urging caution and emphasizing the importance of obtaining medications from reputable sources.
a shortage of branded GLP-1s in 2024 exacerbated the problem, driving more consumers towards compounded options. Reports of rationing and shortages highlighted the fragility of the supply chain and the potential for exploitation by unscrupulous actors.
Looking Ahead
Obesity remains a significant public health challenge, and the demand for effective weight loss solutions is likely to continue growing. The collaboration between Cost Plus Drugs and eMed represents one approach to addressing this need, focusing on affordability and comprehensive patient care. However, the evolving landscape of the GLP-1 market, with shifting alliances and the emergence of new players, underscores the need for continued vigilance and regulatory oversight. The FDA is expected to provide further guidance on the regulation of compounded GLP-1s in the coming months, potentially impacting the availability and safety of these medications.
The debate sparked at SXSW serves as a crucial reminder that access to effective treatments must be coupled with responsible marketing practices and a commitment to patient well-being. As the market matures, it will be essential to prioritize evidence-based care and ensure that individuals receive the support they need to achieve sustainable weight loss and improve their overall health.
Key Takeaways:
- The direct-to-consumer weight loss drug market is facing scrutiny over marketing practices and patient care.
- Companies like Cost Plus Drugs and eMed are focusing on affordability and comprehensive medical oversight.
- Compounded GLP-1s pose safety risks due to a lack of FDA regulation.
- The relationship between Novo Nordisk and Hims & Hers demonstrates the evolving dynamics of the market.
- Continued regulatory oversight and patient education are crucial for ensuring safe and effective access to GLP-1 medications.
The FDA is expected to release updated guidelines regarding compounded GLP-1 medications by the end of 2026. We encourage readers to share their thoughts and experiences with GLP-1 medications in the comments below.
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