Influencers and Telehealth After the FDA Letters

Here is the sentence a telehealth brand does not want to hear from a regulator: "That was not us, that was a creator."

It will not work. A creator who promotes your service for pay or product is part of your marketing, and what they say is something you are expected to control. After the FDA's batch of warning letters this month, that is no longer an abstract risk. This is an educational walk-through of how I would set up an influencer or affiliate program in telehealth so it can survive a careful read. It is not legal advice, so have your counsel review anything you adopt.

What exactly did the FDA do in March 2026?

Start with the facts, and be careful not to stretch them.

On March 3, 2026, the FDA announced warning letters to 30 telehealth companies over illegal marketing of compounded GLP-1s. The agency pointed out that it never approves or reviews compounded drugs for safety, effectiveness or quality, and that they are not generics of approved drugs.¹ Commissioner Marty Makary said, "It's a new era."¹

The claims that drew letters

According to Foley & Lardner's summary, examples included statements that a product was "clinically studied and shown to deliver powerful results," "FDA-approved" implications, claims that a product "contains the active pharmaceutical ingredient in Wegovy," and the phrase "generic Zepbound." It also described the concern that a company can mislead by placing its own brand on a compounded product in a way that suggests it is the compounder.²

What the letters did not say

Neither the FDA announcement nor Foley's summary addresses influencers or affiliates as such.¹² I want to be precise about that, because the lazy headline is "the FDA is going after influencers." That is not what these public sources show. What they show is which claims drew a regulator's attention. Those claims are exactly the ones a creator, handed a loose brief, is likely to improvise.

Why is creator content your marketing?

Because the law and the regulators say so.

The FDA flagged paid promotion in 2025

In September 2025 the FDA announced a crackdown on deceptive drug advertising, citing growing use of digital and social media, including "undisclosed paid influencer promotion," which makes it harder for patients to tell evidence-based information from promotional material.³

The FTC puts responsibility on the advertiser

The FTC updated its Endorsement Guides in June 2023 (the same logic sits behind its fake review rule), adding a definition of "clear and conspicuous," warning that a platform's built-in disclosure tool might not be adequate, and explaining when brands, endorsers and middlemen can each be held responsible.⁴ In its plain-language Q&A, the FTC says advertisers need reasonable programs to train and monitor members of their network, and that "Your company is ultimately responsible for what others do on your behalf."⁵

Scale is why this matters. Ro CEO Zach Reitano explained why his company bought a Super Bowl spot featuring Serena Williams in a conversation posted on March 23, 2026: "It is the only time in the entire year where 100 million plus people gather, right? And ads are part of the product."⁷ The bigger the audience a celebrity or creator reaches, the less room there is for a claim you cannot support. The same standard applies to a creator with 5,000 followers.

Plays here, from YouTube

What claim rules should a telehealth creator brief include?

Write them down, the same way you would for holiday promotions. Hand them over before the first post.

Keep the brief short and the list of approved lines shorter

Give creators a few approved statements they can read or paraphrase safely, plus a clear list of banned phrases. Anything outside those lines goes through review before it posts. Nobody can improvise a compliant medical claim on camera.

How should review and approval work?

Build it as a process, not a promise.

Training is necessary, but not enough

The FTC also notes that training influencers is "important, but insufficient" for people who only receive free products. Companies should ask for disclosure, explain how and monitor the posts.⁵ A welcome email is not a compliance program.

What disclosures do creators and affiliates need?

Clear, close and in plain words.

Material connections

Per the FTC's influencer guidance, a financial relationship includes free or discounted products and other perks, and the disclosure belongs with the endorsement itself. It should not sit only on a profile page, at the end of a post or behind a "more" link. In videos, it should appear in the video, spoken and on screen, rather than only in the description. Simple words like "ad" or "sponsored" work, while vague terms like "collab" or "ambassador" on their own do not.⁶

Affiliate links

The FTC's Q&A says an affiliate relationship should be disclosed clearly and conspicuously near the recommendation. "Affiliate link" alone may not be understood, and a "buy now" button is not enough. "Paid link" next to the link works.⁵

What contract clauses protect you?

Foley's guidance for partner relationships is a useful template, even though it addresses pharmacies and facilities rather than creators. It recommends contracts that allocate compliance responsibilities clearly, with audit rights, notice of regulatory inquiries and termination rights where a risk arises.² Adapt that logic to creators: approval requirements, removal on request, access to analytics and records, and the right to end the relationship immediately.

The sentence that matters

I have built revenue systems for telehealth brands, and in my view the lesson of the letters is not about one channel. It is that every sentence that reaches a patient is your sentence, no matter who says it.

This article is educational and does not constitute legal advice. Telehealth marketing involves federal and state rules, and your counsel should review your program.

Keep building.Ekai