Brazilian health and customs authorities are grappling with a surge in illegal GLP-1 weight-loss drugs, as demand for semaglutide and tirzepatide-based pens outstrips regulated supply. Federal Revenue agents recently uncovered more than 2,500 vials of tirzepatide hidden in milk jam containers on a bus arriving from Paraguay, highlighting the scale of smuggling into the country.
Between 2018 and mid-August 2026, Brazilian authorities recorded 83 suspicious deaths and more than 3,600 complications linked to unregulated weight-loss pens, with over 60% of cases reported in 2025 and 2026 alone. The Brazilian Anti-Counterfeiting Association (ABCF) noted a 100-fold increase in nationwide seizures of illegal GLP-1 drugs from 609 incidents in 2024 to 60,787 in 2025. The black market now accounts for an estimated 51% of 2026 GLP-1 sales in Brazil, according to market research firm Euromonitor International.
The unregulated market is driven by price disparities and supply constraints. A four-week supply of Eli Lilly’s Mounjaro (tirzepatide) starts at R$1,500 for the lowest dose in Brazil, while Novo Nordisk’s Wegovy (semaglutide) retails at R$1,749 for a high-dosage box under a patient support program. In contrast, smuggled Paraguayan alternatives such as T.G. sell for less than R$500 for the same duration, and compounding pharmacies offer local versions like Ozivy for under R$500. The total GLP-1 weight-loss drug market in Brazil is estimated at R$36.8 billion.
Regulators are responding to the crisis. Brazil’s health agency Anvisa approved Ozivy in May as the country’s first domestically produced alternative to Ozempic, aiming to curb demand for unregulated imports. Anvisa Director-President Leandro Safatle acknowledged the challenge of controlling demand but noted that availability of regulated products with transparent pricing could redirect consumers away from illegal sources.
Health professionals warn of severe risks associated with unregulated use. Obesity specialist Dr. Leonardo Sebba described the proliferation of illegal GLP-1 drugs across informal channels, including beauty salons and gyms. Novo Nordisk stated that unauthorized products in Brazil often circulate without medical supervision or regulatory oversight, increasing the likelihood of adverse events.
The human toll is evident. In November, forensic pathologist Flávio Fabres performed an autopsy on Jéssica Ataíde, 31, whose death was linked to complications from an unregulated injection. Authorities reported that food had refluxed into her respiratory tract, leading to asphyxiation. Meanwhile, patients like Pamela Erculano Silva, who lost 17 kg using regulated semaglutide, emphasize the transformative impact of medically supervised treatment.
