All About the Ozempic Shortage

Diabetes patients in Australia, Belgium, and some other countries are dealing with shortages of the type 2 diabetes drug Ozempic. And it’s all because of the wild success of Wegovy, the game-changing obesity drug.

You see, Wegovy and Ozempic are essentially the same drug, a GLP-1 receptor agonist named semaglutide. Global Wegovy shortages have prompted some doctors to order Ozempic for their nondiabetic patients — causing diabetes patients to miss out.

Ozempic has proved to be a powerful therapy for type 2 diabetes, granting both significant improvements to blood glucose numbers and significant weight loss. That weight loss was initially considered just a nice side effect, but it may turn out to be an incredible resource for combatting the global obesity problem. In 2021, the U.S. Food and Drug Administration approved a higher dose of semaglutide for the treatment of obesity. Novo Nordisk, the pharmaceutical giant behind the new medicine, chose to market it under the name of Wegovy, and its release was celebrated as a breakthrough in obesity treatment.

Wegovy’s plan to take over the world hit a snag in December 2021, when Novo Nordisk was forced to suspend production at one American facility because the contractor’s manufacturing practices were not quite up to snuff. The facility is back online now, but the problem only snowballed from there, as supply faltered but demand exploded for the most effective weight loss drug ever released. For months, Novo Nordisk has been unable to keep up with demand for its new wonder drug.

Patients that are prescribed Wegovy, a once-weekly injection, start on a very small initial dose and gradually titrate up over a period of months. The manufacturing pause affected only the supply of those initial low doses, which meant that early users who had already worked their way up to higher doses have largely been able to continue using their medication. But with few lower-dose injection pens available, Novo Nordisk asked doctors to stop prescribing the drug to new patients, and paused all of its promotional efforts.

Many newer Wegovy patients were forced to discontinue their regimen. The rollout, to put it simply, has been a debacle. You can find details in this report from Medscape. Some doctors, too eager to wait for the supply chain shortfalls to end, have started would-be Wegovy patients on Saxenda (liraglutide), intending to later switch them to Wegovy. It’s an untested technique; the fact that it’s catching on just goes to show how desperate doctors and patients are for a truly effective weight loss drug.

The problem for diabetes patients is that doctors have been ordering Ozempic off-label to give to their patients without diabetes in order to replace missing low-dose Wegovy orders. In Australia, the government health authority has told doctors to knock it off, advancing the reasonable theory that diabetes patients should have priority for diabetes drugs. But the damage is done, and many people with diabetes just can’t get the medication they’ve come to rely upon. At the moment, American supplies of Ozempic seem to be fairly secure, and Novo Nordisk promises that its global supply issues will cease before the end of 2022.

Meanwhile, Lilly reports that it is working “around the clock” to keep up with the swelling demand for tirzepatide (Mounjaro), which might just be the best type 2 diabetes drug ever. Mounjaro is a close relative of semaglutide that looks like it may be even more effective for both glucose control and weight loss. The new drug is practically guaranteed to be another blockbuster for diabetes patients, and it will be even more popular when it is (presumably) approved for obesity. Mounjaro was only recently approved for sale in Europe for type 2 diabetes. Lilly has spent billions building out more manufacturing capacity for tirzepatide, hoping to avoid the type of rollout misfortunes that Novo Nordisk has suffered.

As popular as Ozempic has proved to be, many type 2 diabetes experts believe that the drug is actually dramatically underutilized. At a recent conference, experts representing the American Diabetes Association and the European Association for the Study of Diabetes suggested that more patients should be put on GLP-1 receptor agonists like Ozempic as soon as they are diagnosed. Ozempic has also been used off-label for patients with type 1 diabetes and may be especially beneficial for those that have some extra weight to lose. Unfortunately, Ozempic remains quite expensive and is therefore unlikely to be a realistic option for many people with diabetes.


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