Injectable diabetes medications have gained newfound popularity as weight loss solutions—with prescriptions for some drugs up over 2,000% since 2019—and drugmakers have struggled to keep pace with the skyrocketing demand.
For months, shortages of GLP-1 (glucagon-like peptide 1 receptor agonist) medications have made it hard for patients with diabetes to access certain doses of Wegovy, Ozempic, and Mounjaro. The shortages have additionally forced some physicians to reconsider who should get priority when it comes to GLP-1 prescriptions.
“The provider community, of which I’m a part, really needs to take responsibility for the prescriptions that we’re writing, and make sure that the patients most in need are getting their medication,” virtual-first healthcare provider Omada Health Chief Medical Officer Carolyn Jasik told Healthcare Brew.
Those most-in-need patients, Jasik said, are the people already on the medication—particularly those with Type 2 diabetes—who could start to experience side effects (increased blood sugar levels, withdrawal symptoms, and/or loss of glycemic control) if their prescriptions were abruptly discontinued.
Rajesh Aggarwal, a GI surgeon and founder and CEO of Twenty30 Health, agreed that “the worst thing you can do is stop” a patient’s medication.
“There’s no easy answer to this,” he said. “Are we going to start rationing [based on] if you’ve got a higher [body mass index] or you’ve got diabetes? That’s not how we deliver healthcare in this country.”
There have been shortages of Eli Lilly’s Mounjaro—a tirzepatide injection—since December 2022. Intermittent backorders for higher doses were expected to continue through the end of July of this year, while backorders for one lower dose of 10 milligrams (mg) were expected through September, according to the FDA. Various doses of Lilly’s Trulicity (dulaglutide) remain available despite the drug also being in shortage since late 2022.
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Wegovy, which has been in short supply since March 31, 2022, is expected to see limited availability through at least September 2023, according to the FDA. Meanwhile, Ozempic’s 2 mg injection will be in limited supply through mid-August 2023.
Novo Nordisk, the maker of both semaglutide injections, announced in July that it’s working to produce and ship all dose strengths of Wegovy, suspend certain promotional efforts, and ramp up capacity amid trends suggesting that demand for the GLP-1 will exceed current supply capabilities.
Still, the company warned that “many patients will have difficulty filling Wegovy prescriptions” at certain doses (namely 0.25 mg and 0.5 mg) through September. (Novo Nordisk is not experiencing supply shortages for its 1.7 mg and 2.4 mg doses of Wegovy injections.)
The drugmaker also urged providers to “take into consideration the limited supply of the 0.25 mg, 0.5 mg, and 1 mg dose strengths of Wegovy as part of their decision-making when initiating new patients on therapy, recognizing the possibility of disruption in care.” Meanwhile, patients should contact their pharmacy—or another, if supply is not available—about one to two weeks before they need their prescription refilled, per Novo Nordisk’s recommendation.
Jasik noted that pharmacists have helped mitigate the effects of previous drug shortages by ramping up patient education and ensuring that refill requests are submitted early.
“If you go in the day before you need a refill and there’s a supply chain issue, that makes it really hard for the pharmacy to be able to fill it,” she said. “They do a lot of good work on reminding people with medications with supply chain issues.”