Right now finding the drug Ozempic (whose active ingredient is semaglutide) in Spanish pharmacies and in almost any other part of the world is an almost impossible mission for diabetics. The shortage of this drug is global and has been occurring intermittently for months. The main reason is the extremely high demand for this drug, which has grown exponentially during 2022, not by diabetics, but by people who want to lose weight.
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The Spanish Medicines Agency (AEMPS) reported last October that the pharmaceutical company responsible for Ozempic, Novo Nordisk, warned that intermittent availability of the antidiabetic could be maintained through 2023 due to rising demand. In view of this situation, AEMPS recommends that doctors replace Ozempic with other available drugs from the same therapeutic group.
What is Ozempic?
Ozempic is an injectable drug (given by pen once a week) for the treatment of type 2 diabetes, authorized in Europe and other regions of the world since 2017 and 2018. In combination with diet and exercise, it provides good control of blood sugar levels and also limits appetite (less food intake leads to satiety), which favors weight loss.
Clinical trials have also shown that the drug reduces the risk of heart disease (stroke and heart attack) associated with diabetes in the long term. Semaglutide is a molecule that is identical (94% of the sequence) to a hormone produced in the small intestine of the human body: glucagon-like peptide-1 (GLP-1).
Semaglutide is present not only in the drug Ozempic, but also in another drug from Novo Nordisk, Vegovy, which contains a higher dose of the drug. It is indicated for the treatment of obesity with a body mass index greater than 30 or greater than 27, with one or more conditions associated with excess weight. Wegovy is authorized in the United States through 2021 and in the European Union through January 2022. It is not yet available in Spain, but it is expected that it will not be long in coming. The active substance semaglutide is also found in the drug Ribelsus, but in tablets.
Why has its demand increased so much?
many celebrities and influential people, who do not suffer from diabetes or obesity, have promoted the use of Ozempic on social networks to lose weight quickly. newspaper wall street journal An October article described how the American elite is using the drug outside its official sign: “It’s the drug of Hollywood.” One of the most striking cases has been that of Twitter CEO and Tesla director Elon Musk on November 16. he said on his social network who lost 30 pounds due to a combination of fasting, Ozempic/Vegovy, and abstaining from tasty food.
In networks such as Tik Tok, the drug has gained immense popularity. The hashtag #Ozempic currently has 322 million views and #Ozempic weightloss (which translates to Ozempicpérdidadepeso) has over 130 million views. Many people inject the drug as a resource to lose weight, although many of them obviously would not be within the indications of the drug, as they do not suffer from diabetes, nor are they overweight or obese.
Beyond this high demand, Novo Nordisk has experienced problems in the Vigovi supply chain, which has further fueled the use of Ozempic as a weight loss alternative.
The cost of one month of Ozempic treatment, outside of health insurance coverage, can range between $700 and $1,500 in a North American country. In Spain the price is around €130 per pen. However, when the drug is prescribed within the national health system, the patient only pays €4.24, as it is funded.
How is it possible that there is a shortage?
If Ozempic requires a prescription and pharmacies, by law, can dispense it only with a prescription, how is it possible that there will be a shortage during 2022? In addition, one thing is clear: the number of people with type 2 diabetes in the world has not multiplied in recent months.
One of the reasons for the drug shortage is that an unknown percentage of doctors in various countries are prescribing Ozempic off-label (diabetes), a phenomenon known as over prescribing. off label, This behavior also occurs in Spain.
In fact, the AEMPS has explicitly urged prescribers to prioritize the use of GLP-1 analog drugs according to authorized conditions (i.e., glycemic control in patients with type 2 diabetes). There is an implicit allegation that there are doctors who are prescribing it for other purposes, mainly to reduce weight. apart from the prescription off label, it is believed that there may be pharmacies that are dispensing the drug without a prescription. The sum of both factors complicates access to those with diabetes who really need Ozempic.
Why is the use of Ozempic dangerous in healthy people?
The effects of semaglutide have been evaluated primarily in clinical trials in diabetic patients and obese patients. Therefore, the adverse effects it can cause in individuals without these health problems are little known. Like all drugs, Ozempic can cause health problems. The most frequent side-effects are nausea and vomiting, but it can also cause diarrhoea, constipation, fatigue or malaise. In the most severe cases, it can cause inflammation of the pancreas, kidney problems, allergic reactions, or gallstones.
Semaglutide is not a miracle drug either. After 68 weeks of treatment, overweight or obese patients were able to lose an average of 15% of their weight with a combination of physical exercise and diet. The major problem is the rebound effect after discontinuing the drug. After a year of not taking it, people can regain two-thirds of their previous weight. The story of the Olympic weight loss is the story of a society that wants to lose weight with as little effort and as quickly as possible, even if it means putting their health at risk.