People are using life-saving diabetes drug Ozempic to lose weight. Now it's in short supply.
A drug used to treat Type 2 diabetes has become wildly popular due to one of its side effects: weight loss.
Demand for semaglutide, the generic form of brand name drugs Ozempic, Wegovy and Rybelsus, has soared over the past year, according to physicians and to the pharmaceutical company that makes the drugs, Denmark's Novo Nordisk. And non-diabetic patients seeking slimmer waistlines appear to be driving some of the growing demand.
"A year ago I didn't feel like there was as much interest. In the past six months, people asking about Ozempic and how it works and if they're a candidate has really increased a lot," New York plastic surgeon Dr. Jennifer Levine told CBS MoneyWatch.
Endocrinologist Dr. Gregory Dodell, of Central Park Endocrinology, also said he has seen an increase in inquiries from patients about Ozempic. He regularly prescribes it to patients with Type 2 diabetes, but is hesitant about using it for weight loss.
"It works while people are taking it, but once people stop they gain back two-thirds of the weight they lost if not more, and sometimes weight loss plateaus so people have to go off or stay on it definitely," he said.
"We couldn't even get samples"
Indeed, demand has surged so quickly that Novo Nordisk acknowledged it is experiencing "intermittent supply disruptions" for Ozempic. It attributed the shortage, which it expects will persist through mid-March, to "the combination of incredible demand coupled with overall global supply constraints."
While 1 milligram and 2 mg doses of Ozempic are currently available, an Ozempic pen that delivers 0.25 mg and 0.5 mg doses is in short supply, according to the Food and Drug Administration. The FDA also cited rising demand as the reason for the shortage.
In 2021, the FDA approved Wegovy — which contains a higher dose of semaglutide than other brands — for chronic weight management in adults with obesity. Supplies ran short a year ago, but it's now widely available, according to the FDA. Novo Nordisk said in a statement that it took "significant measures" to ensure adequate supply of the drug in the U.S. this year.
When Wegovy first became hard to come by, however, many patients who relied on the drug for weight loss turned to Ozempic. That in turn constrained supplies of the diabetes drug.
Dr. Dodell said at one point last year the shortage was so severe that he resorted to handing out Ozempic samples to patients who couldn't access their regular courses of the medication.
"It's horrible. It's so bad. Endocrinologists are banging their heads against the wall," he said. "During one period, we couldn't even get samples."
Ozempic is FDA-approved to treat Type 2 diabetes, but is not approved for chronic weight management. However, physicians can prescribe an approved drug for an unapproved use. When they do, that's called "off-label" use.
"While we recognize that some health care providers may be prescribing Ozempic for patients whose goal is to lose weight, Novo Nordisk does not promote, suggest or encourage off-label use of our medicines," the company said in a statement to CBS MoneyWatch.
Novo Nordisk diabetes care sales jumped 56% in 2022, while its obesity care sales shot up 101%. according to the company.
Appetite suppressant
Ozempic is popular among patients with Type 2 diabetes because it is more effective and considered safer than treatments like taking insulin. More than 30 million, or 1 in 10 Americans, have Type 2 diabetes, according to the Centers for Disease Control and Prevention.
But Ozempic has also grown popular for the effect it has on patients' appetites.
"One of the unintended consequences of these medications that are indicated for managing Type 2 diabetes is they also suppress your appetite and slow the gut down, so you feel fuller," said Dr. Said Ibrahim, senior vice president of Northwell Health's Medicine Service Line and chair of its two leading hospitals. "They send a signal to the brain that you are full, and that is really the weight loss property of these treatments and that's what is causing the demand because everybody wants to lose weight."
Ibrahim also has noticed an increase in physicians prescribing Ozempic for off-label uses such as weight loss.
"It's not entirely indicated just for weight loss — you really have to have co-morbidities like high blood pressure — but some physicians are offering this treatment to patients who can afford it, and that's the reason why things are getting short," he said.
Social media hype
Typically, Ozempic is covered by insurers only when it is prescribed as indicated for people with Type 2 diabetes. In other words, patients who are using it to shed extra pounds must pay out-of-pocket. And the costs are steep. On average, Ozempic costs between $1,000 to $1,200 per month.
One reason for the exorbitant price is the attention off-label usage of the drug is getting on social media, according to Ibrahim. For example, Elon Musk has recently tweeted about relying on drugs like Wegovy and Rybelsus, a pill form of semaglutide, to maintain a lean physique. Asked what his secret is to looking fit, the billionaire owner of Twitter and Tesla CEO replied he relies on "Fasting + Ozempic/Wegovy."
Fasting + Ozempic/Wegovy + no tasty food near me
— Elon Musk (@elonmusk) November 16, 2022
Others on social media have complained that friends and loved ones who are diabetic cannot obtain the medication they rely on to regulate the condition.
"My husband can't get his Ozempic that he needs to control his diabetes. There is a shortage due to being prescribed for weight loss. He needs it by tomorrow and there is none to be had," one person tweeted.
My husband can’t get his Ozempic that he needs to control his diabetes. There is a shortage due to being prescribed for weight loss. He needs it by tomorrow and there is none to be had
— Jacquie Blue (@jcdeanrn) January 31, 2023
"What's the story with Ozempic? I have a friend on Twitter who can't source this drug and it's the only medication that controls his diabetes properly. Can any of you help?" another person tweeted this week.
@PharmGuildAus what’s the story with Ozempic? I have a friend on Twitter who can’t source this drug and it’s the only medication that controls his diabetes properly. Can any of you help?
— Aparachick 😷 (@aparachick) February 13, 2023
Ibrahim is concerned about fairness issues around who gets access to Ozempic.
"There are a lot of people who aren't overweight and just want to lose a little weight," he told CBS MoneyWatch. "While they can't get these kinds of drugs through insurance, they can afford to buy them, and that's part of the problem in terms of the supply issues."
Ibrahim also said physicians should exercise caution in deciding to whom they prescribe the drugs, which is key to maintaining adequate supplies.
"I don't think the idea of the company just increasing its production is the right strategy at the moment because they're making enough for the right people," he added.
Still he's concerned about access for patients who are diabetic and obese, and resulting inequities.
"A large number of these patients happen to be in socioeconomically disenfranchised communities, so for them not to have access to these very good medications is a major national issue," Ibrahim said. "We need to get ahead of this and find ways to make sure this doesn't become another huge source of disparities in health care."