There are 186 drugs on the FDA’s shortages list. Among them are the antibiotic amoxicillin, the ADHD drug Adderall and now Ozempic, which used to treat Type 2 diabetes.
Pharma company Novo Nordisk, maker of the weekly injectable drug Ozempic (semaglutide), touts its weight loss benefit in its advertising. Adults, the company claims, lost up to 12 pounds. But that’s not why the drug was first approved by the Food and Drug Administration (FDA) in 2017.
Novo Nordisk’s data shows that patients with Type 2 diabetes are seeing their hemoglobin A1C levels drop to under 7. According to the American Diabetes Association, an A1C level of 6.5 and above indicates diabetes.
Normally, obesity physicians prescribe Wegovy for weight loss. But about two months ago, supplies of Wegovy dwindled because of surging demand, driven, in part, by social media promotion. And so obesity physicians, including Dr. Devika Umashankar of Hartford HealthCare, began prescribing Ozempic for weight loss because both Wegovy and Ozempic contain the same medication – semaglutide – but are dosed differently for weight loss and Type 2 diabetes.
“And what we have seen is, with this approach, it has now caused Ozempic to become a shortage,” Umashankar says. “I can tell you, it’s become more prominent in our clinical population, in the last one to two months, where patients are unable to find the medication within their local city or town.”
It is common for physicians to prescribe drugs for off-label use. For example, the heart failure drug ivabradine is frequently prescribed to manage symptoms in patients with postural orthostatic tachycardia syndrome (POTS). Gabapentin, approved for seizures, is prescribed off-label for hot flashes.
Novo Nordisk told Connecticut Public Radio that its global manufacturing facilities are now operating 24/7, seven days a week, to help ease supply constraints. The supply is expected to be back up by March of 2023. In the meantime, doctors are prescribing alternatives. The weekly injectable Trulicity from Eli Lilly is a close substitute.
But, Umashankar said, there “appears to be a little bit of a shortage as well” for Trulicity. “Not that it’s been formally announced, but it’s been backordered.”
So she and her colleagues are switching patients to a daily injectable also from Novo Nordisk.
“We are switching patients to other GLP-1 medications,” she said. “For example, if Trulicity is not available, then Victoza.”
Umashankar says patients must call their doctors for an alternate diabetic drug. Another adverse impact of this shortage, she said, is that patients have lower compliance levels with a daily injectable medication, compared to a weekly one.
