| Federal and state regulators are struggling to keep pace with the booming peptide market, leaving consumers exposed to untested and potentially dangerous products even as the Trump administration pushes to make certain peptides more widely available. An investigation by Lauren Weber in The Washington Post newsroom found major gaps in oversight of peptides, which have exploded in popularity at medspas, wellness clinics, and online retailers with promises of weight loss, antiaging, and faster recovery from workouts or injuries. After contacting pharmacy, medical and nursing boards in all 50 states and Washington, D.C., she found that most regulators lack the authority or resources to police the growing industry, and few have taken disciplinary action against practitioners selling or administering peptides. Why it matters: The findings come as Health Secretary Robert F. Kennedy Jr. moves to loosen what he says are illegal restrictions around allowing compounding pharmacies to produce some of these peptides. Kennedy, a self-described “big fan” of peptides, has made expanding access to them one of his priorities. While career scientists at the Food and Drug Administration have concluded that more safety testing needs to be done before they’re allowed to be produced, a federal advisory panel Thursday recommended that the agency allow pharmacies to manufacture four peptides. Breaking: On Friday, the panel recommended that another two — epitalon and semax — should also become eligible. A third peptide the panel was evaluating, emideltide, is not being recommended for availability through compounding. While there are some regulations for compounding pharmacies, the products they make aren’t evaluated by the FDA for safety or efficacy like other prescription drugs. Joshua Sharfstein, who served as principal deputy FDA commissioner during the Obama administration, said that if peptides are regulated similarly to supplements — and not required to undergo clinical trials for effectiveness — it’s probably impossible to “distinguish between snake oil and legitimate medicine.” Key details from The Post’s investigation: - Several regulators described an industry operating in a regulatory gray area, with reports of peptides mixed in private homes, products falsely claiming to come from legitimate manufacturers, and medspas administering substances that have never been approved for human use.
- The FDA also faces resource constraints. The agency has struggled to retain drug inspectors in recent years, while former acting FDA commissioner Janet Woodcock described oversight of peptides as a “crazy jigsaw” split among federal and state authorities.
- State enforcement has been sparse, and many states — including Alabama — have no regulatory authority to inspect medspas. Only eight pharmacy boards reported publicly disciplining practitioners or pharmacies in peptide-related cases, while just two medical boards identified physician sanctions. Critics say the state medical, pharmacy and nursing boards that typically oversee the nation’s health practitioners are historically flawed, suffering from chronic understaffing.
- Ohio has emerged as a notable exception because state law allows its pharmacy board to inspect medspas; the state has suspended roughly 50 medspa licenses since early 2025 for selling unregulated peptides and other unapproved drugs.
The findings underscore growing concern that oversight has failed to keep pace with a rapidly expanding wellness market, even as peptide advocates argue broader legal access would move consumers away from unregulated online sellers. Shot: The Trump administration pushed back on the notion that the FDA is struggling to handle oversight of these products, with a spokesperson from the Department of Health and Human Services telling Lauren that the FDA is using “its full range of enforcement authorities” to protect consumers from illegally marketed peptide products. “Claims that the FDA is unable to carry out its mission are false,” said Emily Hilliard, an HHS spokesperson. Chaser: “The FDA is really in a position where they have to take the most dangerous drugs and focus on those,” said Susan Alverson, the director of regulatory affairs for the Alabama Board of Pharmacy. This means that states are being left to fill in the gaps — but The Post’s investigation suggests that many of them aren’t. Read the full story: “Peptide boom has states scrambling to protect consumers, Post investigation finds.” Top state insurance regulators are still pressing policymakers in Washington to revive enhanced subsidies that help people afford health insurance on the Affordable Care Act market, but which expired earlier this year. The issue was the subject of a massive fight between Democrats and Republicans on Capitol Hill last year. Although the policy has some support from moderate Republicans in competitive elections, most Republican lawmakers oppose the subsidies on an ideological basis. The impasse makes it unlikely for it to come back up among federal lawmakers in the near term. But the issue was the main topic discussed at a panel during the Michigan Association of Health Plans conference Friday that featured state insurance officials. Reviving the expanded subsidies is “huge,” said Ann Gillespie, the director of the Illinois Department of Insurance. “Affordability is going to continue to be an issue, if for nothing else than the fact that there’s new technology, new drugs, new things coming out all the time, and it always raises the price,” making the tax credits “critical.” → Since the enhanced premium subsidies expired, monthly health insurance costs have increased for millions of Americans. There are still some subsidies for low-income people through the Affordable Care Act, but those making more than 400 percent of the federal poverty level lost the financial assistance. (For a single person, that’s about $60,000. In a four-person household, that’s equal to roughly $125,000.) Anita Fox, the director of Michigan’s Department of Insurance and Financial Services, urged the crowd of insurance and health care executives to press federal policymakers to pick it back up. Brian Webb, director of health and life policy at the National Association of Insurance Commissioners, said the lack of affordable options on the individual market is causing health plans with skimpy coverage to flourish. “With the rates going up, with the subsidies going away, with troubles in the small-group market, there’s this constant drumbeat of these alternative type plans out there,” Webb said, “whether it’s health care-sharing ministries, which are completely unregulated, and there are association health plans — some of them are legitimate; some of them are not.” “These alternatives [are] being sold out there, through social media and the internet. It’s so easy just to keep getting these things out there that say, ‘Hey, you want insurance?’” Webb added. He also pointed to a novel type of health insurance plan that allows people to become “partners” in digital management companies, thereby giving them the ability to buy health insurance. “We’re seeing a growing number of those. Some of them are providing some coverage; most of them provide no coverage. It’s just completely illegitimate in what they’re doing,” Webb said, mentioning ongoing litigation over their legality. Insurance regulators also say delayed Affordable Care Act rules and a court order pausing many of the administration’s planned changes have made it harder for insurers to prepare for next year’s marketplace offerings. “Even after [health insurance] rates have been filed, we still have no idea what the market’s going to look like in 2027” following the court actions, Webb said. “Are we going to be able to get everything up and running and in place for open enrollment or not? That’s the question. And, as we keep saying, this kind of instability just leads to higher rates.” “CDC expands largest known U.S. cyclospora outbreak to 9 states,” The Post’s Lena H. Sun and Jenny Ye report. “‘The Child Is Terrified’: Doctors on the Front Lines of a Measles Comeback Speak Out,” Amy Maxmen writes at KFF Health News. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from The Washington Post newsroom. Learn more about WP Intelligence. | 
