“It’s been going on for over a month now,” said Dr. Miguel Parilo, of Bull Family Diabetes Center in Oakwood. “The shortage was specific to Ozempic at the higher doses and has progressed to affecting all doses.”
In response to the shortage, doctors were prescribing patients the lower doses to match what pharmacies had in stock before switching patients to other drugs within the same class.
“All these once a week injections of that class are, in some degree, of short supply, because of their off label use for non-diabetic related obesity,” said Parilo.
When prescribers use a medicine for an indication other than what the FDA approves it for, that is considered off-label use, Parilo said. Ozempic has been approved by the FDA for the treatment of Type 2 diabetes, and another semaglutide drug, Wegovy, has gotten FDA approval for the treatment of obesity. Wegovy is the same compound as Ozempic but a different version of the drug.
“Wegovy was used very liberally. If it becomes in short supply, people therefore start using Ozempic. Ozempic then becomes in short supply, and then we’re in the dilemma that we’re in at this point,” Parilo said.
The manufacturer, Novo Nordisk, expects full availability of Ozempic to be back up by mid-March, according to the FDA’s drug shortage database. For now, local residents using Ozempic have had to adapt by switching to different medications, visiting multiple pharmacies or going without the drug.
“We do suspect some of that was being overprescribed for weight loss,” said Justin Coby, a pharmacist and the director of pharmacy at Cedar Care Village Pharmacy. “They (patients) are struggling to find product. Probably for the past two to three months we’ve struggled to keep that in stock. We’ve had patients who have had to go without; we’ve had patients who had to be switched over to a different product.”
For patients who get switched to a different drug, it then sometimes causes the new drug to go into short supply.
Parilo said it has been inconvenient for his patients who use Ozempic and impacts their ability to keep their Type 2 diabetes under control.
“We have to find an alternative treatment. We sometimes have to use lower doses of Ozempic, and what happens during that period of time is diabetes control suffers. The blood sugar measurements and the weight benefits they were experiencing, they lose some of those benefits, and sometimes we don’t have an acceptable alternative,” Parilo said.
The perimeters of the patient’s diabetes can suffer if they must go without the drug. Switching to another option also runs the risk of the patient not tolerating the new drug or the risk of the drug not being as effective.
Semaglutide drugs have been found to be the best at controlling blood sugar, Coby said. If a patient’s A1C test — which is a blood test that provides information about average levels of blood glucose, or blood sugar, over a 90-day period — remains high, it can lead to vision loss or loss of portions of limbs because of bad blood flow.
“Once the word gets out and the medical community understands, I think it will help because we’re going to slow down the prescribing of it,” Coby said. The price of the drug is not expected to go up as pharmaceutical companies set prices with insurance companies at the beginning of the year, he said.
“There are more affordable, generic medications that people can be placed on in place of this, so it’s not a situation where Type 2 diabetics are going to be completely left out in the cold,” Coby said. “However ... it’s a disparity, especially for those in the marginalized populations of our country, it’s a disparity they can’t access this medicine while celebrities do if you don’t actually have Type 2 diabetes.”
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