Weight loss Medication Drug ShortagesNov 18, 2022
A little more than a year ago, the glucagonlike peptide-1 receptor agonist (GLPIRA) semaglutide that was formulated to treat obesity (Wegovy) had a roaring takeoff, with increasing patient demand when the United States Food and Drug Administration approved it in June 2021. However, the beginning dosages of the Wegovy brand of semaglutide disappeared starting in late 2021 and have not been found to this day, which is problematic for both patients and the healthcare providers who treat them.
Because of semaglutide's proven safety and efficacy at the subcutaneous dose of 2.4 mg delivered once a week to produce at least 15% weight loss in half of the people who received it, as documented last year in results from one of the drug's pivotal clinical trials, the release of Wegovy last year was hailed by obesity medicine specialists and others as a "game changer" for treating people with obesity. This was due to the fact that the drug was able to produce this level of weight loss in
But in the months that followed the FDA's approval of semaglutide for the treatment of obesity (it also obtained an FDA marketing in late 2017 as Ozempic for the treatment of type 2 diabetes), a shortage of Wegovy occurred across the globe, including in the United States of America.
According to a report published in December by Novo Nordisk, the company that manufactures and promotes the agent, a manufacturing glitch caused the primary facility to cease production of Wegovy injector pens destined for the United States for a period of several months beginning in late 2021.
The difficulty with Wegovy production appears to have minimal impact on the supply of semaglutide manufactured as Ozempic, which is also sold by Novo Nordisk, particularly in U.S. pharmacies, however, Wegovy Supply and demand have had a significant impact on Ozempic availability in Australia.
Feedback of Medical Specialists
According to Lauren D. Oshman, MD, a family and obesity medicine specialist at the University of Michigan, Ann Arbor, she has "stopped giving Wegovy to new patients" since about the beginning of 2022. "It is incredibly frustrating to not be able to provide people [who are obese] with the best treatment that is now available." Although she does her best to tailor obesity therapy to the specific clinical requirements of each patient, she emphasizes that a GLPIRA is not always the drug of first resort for everyone who is obese.
According to Dr. Oshman, who was interviewed for the article, switching from Saxenda to Wegovy or from Wegovy to Saxenda "would be reasonably evidence-based medicine." She has been successful in switching a "handful of patients" from Wegovy to Saxenda in order to deal with Wegovy shortages; however, she has not yet transferred anyone back to Wegovy after a Saxenda switch.
The supply side for Wegovy became so hopelessly broken that just a few months after US sales began and immediately skyrocketed, Novo Nordisk made the remarkable decision to pull starting doses of Wegovy from the market in order to make it much harder to initiate patients (semaglutide and other GLPIRAS require gradual dose ramp-up in order to avoid gastrointestinal side effects).
We discuss prescribing issues and tips on how to deal with them in our course. If you are struggling with drug costs and supply issues, sign up today and learn how to help your patients. While learning about obesity medicine, you can obtain Continuing Medical Education credits. Drs. Michelle and Jeffrey Shukhman are two physicians who are both boards certified in obesity medicine and are teaching this course. It is a self-paced course and you can easily fit it into your busy schedule with the short modules. Enroll right away at obesitymadesimple.com! You can contact us by email at [email protected] if you have any questions.
Zoler, Mitchell, Frustrations, Workaround triggered by drug shortage, Volume 55, September 9, 2022, MDedge.com/Internalmedicine