Wonder weight loss drugs, such as Wegovy, have hit the headlines in recent weeks. They can help people shed 10%-15% of their bodyweight, largely by suppressing their appetite.
However, some of these weight loss jabs are based on semaglutide, first developed for treating type 2 diabetes. This means the boom in demand for ‘magic bullet’ weight loss jabs is contributing to a major shortage in key diabetes medication, says a leading expert.
Leading blood testing expert, Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, said, ‘There is now a global shortage of semaglutide-based drugs for treating diabetes. Key among these is Wegovy’s sister drug, Ozempic, used by the NHS as a treatment for managing blood glucose levels in people with type 2 diabetes, which accounts for 90% of all diabetes cases in the UK. This will result in both acute and chronic medical complications if left unmanaged.
‘Both Wegovy and Ozempic are produced by the Danish pharmaceutical giant Novo Nordisk. The problem is that Ozempic has increasingly been prescribed off label (outside of its approved licence) for weight loss as an alternative to Wegovy. Now Novo Nordisk is warning of shortages of Ozempic stretching into 2025.
‘Ozempic and Wegovy became a social media phenomenon earlier this year as a weight loss cure, with demand for semaglutide spiralling after celebrity endorsements. That’s not what Ozempic was intended for and has resulted in demand far outstripping supply.
‘Now Novo Nordisk’s official weight loss drug, Wegovy, is finally available in the UK on the NHS and as a private prescription. However, though this will relieve the demand on critical Ozempic stocks, supplies of all semaglutide-based treatments remain limited. Patients being treated for type 2 diabetes need to know that there are sufficient stocks of this treatment and, if not, patients need a plan to mitigate against supply disruptions.
‘Novo Nordisk now has a market cap of $419.79bn, making it the world’s 17th most valuable company. Astonishingly, the market value of the Danish company has exceeded the size of Denmark’s domestic economy (£395.40bn). We are keen for Novo Nordisk to continue concentrating on the production of vital diabetes treatments, over other semaglutide-based products. The company has stated that it will prioritise treatments for existing patients, rather than focusing on introducing new people to Wegovy weight loss treatments.
‘We support Diabetes UK in urging clinicians to follow Department for Health and Social Care guidance, which states clinicians should not prescribe these drugs outside of their licensed use until the supply issues are rectified.
‘It’s not only in the UK that restricted supplies are causing problems; there’s a worldwide shortage. America’s FDA lists Wegovy and certain Ozempic dosages as being in short supply. So too does Australia’s Therapeutic Goods Administration (TGA), which says supplies of Ozempic will remain limited to diabetes treatments only until at least the end of December 2023, and that patients prescribed Ozempic for other conditions should contact their doctor to have their treatment reassessed.
‘The shortage doesn’t only impact on semaglutide-based drugs. All “GLP-1 analogues”, as this family of drugs are known, are in short supply. These include the brands Ozempic, Rybelsus, Trulicity, Victoza, Saxenda, Byetta and Bydureon. This appears to be pan-market disruption, complicated by exceeding demands.
‘All these drugs:
- signal to your body to make more insulin (the hormone that controls the amount of sugar in your blood)
- reduce the amount of glucose (gluconeogenesis) that your liver makes
- slow down the digestion of food, so that it takes longer for your body to absorb the sugar from meals
- reduce your appetite by increasing satiety
‘It’s the final effect that has created this unexpected surge in demand. However, there is some welcome news of another GLP-1 analogue drug just about to reach the UK. The National Institute for Health and Care Excellence (NICE) has approved the use of tirzepatide (brand name Mounjaro) for treating type 2 diabetes in England and Wales. Supplies of this new drug should come on stream within three months.
‘Again, it’s vital this new medication is prioritised as a further treatment for type 2 diabetes, rather than for other purposes. It, too, is likely to be in hot demand by people seeking to lose weight the easy way. In the US, clinical weight loss trials show Mounjaro is even more effective than Ozempic, with patients achieving 26.6% weight loss over 84 weeks.
‘By 2030, diabetes cases in the UK will have risen by 50% compared to 2007 levels, according to Diabetes UK. Unmanaged or undiagnosed diabetes is one of the leading causes of mortality. Diabetes is usually linked to factors such as weight, lifestyle, age and family history. One in ten people will have diabetes by the end of the next decade, and one in three will be at a much increased risk of developing it. The truly frightening thing is that it is quite common for people to have diabetes and not know about it.
‘Fortunately, there is a simple blood test that will categorically confirm whether or not you have type 2 diabetes – even in the earliest stages, long before any symptoms have developed. This home test checks your levels of HbA1c. This biomarker is used to confirm whether you have (or are at risk of developing) diabetes. For anyone who already knows they have diabetes, regular HbA1c checks are also essential to monitor progress.’
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