Semaglutide is in short supply. That is the generic name for a weight loss drug from the class of glucagon-like peptide 1 (GLP-1) receptor agonists. You may have heard of them under the brand names, Ozempic, Rybelsus, and Wegovy. Injections are taken weekly, and a month’s supply is around $1,400 if paying cash with a GoodRx coupon. Semaglutide is also prescribed for diabetes that does not respond to other treatments. Obese patients can expect to lose anywhere from 15% to 20% of their body weight. That is why it is in high demand and supplies are tight. The drug class is new and it works. Food cravings fall and patients report forgetting to eat. Oprah even admitted taking it.
With supplies tight compounding pharmacies have taken advantage of loopholes in regulations both in the U.S. and abroad to make their own knockoff versions. The manufacturer Novo Nordisk, is suing to stop them.
Including the newest lawsuits, Novo Nordisk has filed 12 legal actions against compounding pharmacies, medical spas and weight loss clinics allegedly selling dupes of Wegovy and Ozempic. The company said it has received preliminary injunctions in six of those cases.
Patients generally start low and increase their dose every four weeks. Some people apparently want to get ahead of the game and increase their dose more than is recommended. Poison centers have experienced a nearly 1,500% increase in calls related to injected weight-loss drugs.
From January through November, the America’s Poison Centers reports nearly 3,000 calls involving semaglutide, an increase of more than 15-fold since 2019. In 94% of calls, this medication was the only substance reported.
In most of the calls, people reported dosing errors, said Dr. Kait Brown, clinical managing director of the association.
“Oftentimes, it’s a person who maybe accidentally took a double dose or took the wrong dose,” Brown said.
Recently the U.S. Food and Drug Administration (FDA) warned of counterfeit versions entering the supply chain and being sold by pharmacies. The federal agency has seized thousands of counterfeit doses. The FDA is testing the seized medications to see what is in them. The counterfeit medications could be inert or even harmful ingredients. Or they could be unlicensed knockoffs that actually work. Nobody is saying. The FDA and manufacturers have found that fighting counterfeit copies of the medications popping up is like playing “whack a mole.” Med spas, weight-loss clinics and online pharmacies are accused of selling counterfeit versions. The battle with counterfeits is made worse by the shortage and the high price.
The shortage, along with the worry of counterfeit medications, is also a problem for physicians and clinics that need the drug for diabetes patients.
Despite the different indications, people have been using Ozempic and Rybelsus for weight loss, which has contributed to decreased access for patients with T2D who need it to manage their condition. An analysis of electronic health records shared with CNN by Epic Records estimates that around 1.7% of all Americans have been prescribed a semaglutide medication in 2023 alone, reflecting a nearly 40-times increase over the past 5 years. Additionally, the increased popularity of Wegovy is making it harder for patients with overweight or obesity who have been using it for weight loss to access the treatment that has been working for them.
There is also an on-going debate about whether health insurance should pay for Semaglutide in patients who want it mostly for weight loss but could potentially benefit their health in the process. The prevalence of obesity is 42% of adults in the U.S. The cost of these new weight loss drugs varies from one health plan to another, but insurance companies pay around $10,000 for each patient on the medications. If 40% of enrollees qualify for the drugs you can expect your health insurance premiums to skyrocket. Obesity is correlated with other health concerns and drug companies are funding research to broaden who qualifies for coverage by insurers.