Australia is experiencing a shortage of Ozempic also known as semaglutide. This shortage is impacting many patients with type 2 diabetes who can’t get access to this extremely effective glucose-lowering drug.
What is Ozempic?
Ozempic is an approved treatment for adults with type 2 diabetes mellitus in addition to diet and exercise. This is a welcome treatment for many of the more than 1 million adults with type 2 diabetes in Australia. For more information about type 2 diabetes click here
How does it work?
It belongs to a group of medications called glucagon type 1 agonists. These medicines mimic the hormone Glucagon-like peptide 1 (GLP-1) in our bodies to lower blood sugar after a meal. GLP-1 hormones are produced in the gut and are sometimes called encretins because they boost insulin secretion. GLP-1 also increased the feeling of fullness by acting on appetite centres in the brain as well as slowing stomach emptying. Medicines which are called agonists act by binding to a receptor on a cell which results in the same response as when the usual agent binds to the cell. When levels of GLP-1 are low, taking a GLP-1 agonist will stimulate the production of insulin and slow the stomach emptying. This means people will feel fuller for longer.
Why is there a shortage in Australia?
In Australia medicines are approved and regulated by the Therapeutic Goods Administration (TGA). Ozempic is currently approved for use in Australia only as a treatment for type 2 diabetes. The TGA prohibits advertising for off-label indications to prescribers or the public. However, medicines are sometimes used for off-label purposes. This means a medicine is used for a different indication or condition that is not included in the product information approved by TGA. Because of the possible weight loss effects, there has been a large increase in demand for the drug by people without diabetes who want to lose weight and this demand has outstripped supply.
Can Ozempic help with weight loss?
Obesity is a growing chronic disease in Australia that currently impacts more than 1.3 million adults. It can also lead to type-2 diabetes and prediabetes. Research studies support the potential of GLP-1 agonists as a weight management treatment, click here for more. Importantly the benefit of Ozempic was observed in conjunction with diet and exercise. In the USA, Ozempic was approved in 2021 in adults with obesity or overweight and at least one obesity related condition (FDA approval). These conditions include high blood pressure, type 2 diabetes, or high cholesterol). In February 2022, the UK has introduced draft guidelines for the use of Ozempic.
The increased off-label use of Ozempic in Australia highlights the need for approved and effective treatments for obesity. Because it is not approved by the TGA, Ozempic currently is also not listed on the Pharmaceutical Benefits Scheme (PBS) for weight loss. This means the cost of the treatment is not subsidised by the Government and can cost more than $130 for one 1.5mL pen.
If you are having difficulty accessing Ozempic for your type 2 diabetes, what can you do?
The TGA have published a joint report and are asking people who use Ozempic for their type 2 diabetes to contact their usual pharmacy as early as possible to avoid delays having their prescription filled. They are also asking health professionals and pharmacists to prioritise treatment for type 2 diabetes. People with type 2 diabetes who use Ozempic are also encouraged to discuss alternative treatment options with their doctor whilst shortages remain. Availability of Ozempic is expected to be limited in Australia until December 2022. You can read the joint statement here
Sources
https://www.yourhormones.info/hormones/glucagon-like-peptide-1/
https://www1.racgp.org.au/ajgp/2021/may/off-label-medicine-use