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EXPERTS say it isn’t fair or accurate to blame people with obesity for the current shortage of semaglutide (sold as Ozempic).
The Therapeutic Goods Administration (TGA) recently advised that there will continue to be shortages of Ozempic until March 2023.
The glucagon-like peptide 1 receptor agonist (GLP1-RA) medication is supplied by pharmaceutical company Novo Nordisk. It’s approved by the TGA and subsided by the Pharmaceutical Benefits Scheme (PBS) for the treatment of type 2 diabetes when certain conditions are met.
However, it has been prescribed off-label on a private prescription to treat other conditions, including obesity.
In a statement to InSight+, the TGA wrote:
“The TGA does not have the power to regulate the clinical decisions of health professionals and is unable to prevent doctors from using their clinical judgement to prescribe Ozempic for other health conditions.”
However, many media outlets have reported that it’s grown in popularity because of social media platforms such as TikTok, where some members have promoted it to lose weight (here, here and here).
Dr Priya Sumithran, an endocrinologist at Austin Health and Group Leader of the Obesity Research Group at the University of Melbourne, doesn’t believe that’s accurate.
“A lot of the reporting has blamed people with obesity who were using the medications for weight management. But I don’t think that’s fair or accurate. Social media is obviously important in raising awareness of certain available treatments. But ultimately, doctors are prescribing these medications to their patients, where they are considered the best treatment to improve that person’s health,” she said.
The supply ran out quicker than expected because demand is high.
“I don’t think that we can just blame TikTok for the demand. The demand is high because there’s a whole lot of people, whether they have diabetes, whether they have obesity without diabetes, that really need effective treatments. These effective treatments came on to the market and people are using them,” she explained.
Should Ozempic be prioritised for patients with diabetes?
There have been calls to prioritise access to patients with diabetes, but Dr Gary Deed, Chair of the Royal Australian College of General Practitioners (RACGP) Specific Interests Group on Diabetes, doesn’t believe one group should have priority over another.
“All patients deserve prioritising on an individual basis, and it’s a hard call to objectively place preferences over one group of patients when each may be deserving of having access to quality medicines.
“Obesity is a disease that we have paid lip service to for too long. Diabetes is a complex illness that needs careful stewardship to support patients’ quality of life and prevent complications. So, each group deserves to have equitable access,” he told InSight+.
There are PBS-supported options for people with diabetes, but those are also rapidly dwindling in supply.
The RACGP have been advised that twice daily exenatide (sold as Byetta; AstraZeneca) will also be unavailable.
The GLP1-RA Dulaglutide (sold as Trulicity; Eli Lilly), is also expected to have limited availability.
The RACGP has provided the following guidance:
- do not initiate new patients on either of these agents; and
- consider individualised approaches to people with diabetes such as the following:
- review the need for a GLP1-RA. If clinical response was limited, reconsider the need to prescribe and whether any replacement is required — switch to an alternative GLP1-RA; liraglutide is not subsidised by the PBS, is administered once daily, and has evidence of cardiovascular benefit;
- consider sodium–glucose cotransporter type 2 (SGLT2) inhibitors as an alternative oral therapy, especially in patients who also have cardiovascular disease, multiple cardiovascular risk factors, and/or kidney disease;
- dipeptidyl peptidase‐4 (DPP4) inhibitors may be useful in patients who do not have cardiovascular disease, multiple cardiovascular risk factors or kidney disease, and are unable to achieve optimal blood glucose levels;
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- sulphonylureas or insulin (initiation or titrated doses) can also be considered, but they may lead to risks for hypoglycaemia and weight gain.
PBS-subsidised obesity options
Dr Sumithran highlighted that the popularity and effectiveness of these treatments raise the question about current therapeutic options available for people with obesity. There are only limited medications available and none of them are PBS-supported.
“Effective treatment options for obesity do need to be made available in a way that doesn’t perpetuate health inequities, and that means making effective treatments affordable for people who can’t afford to pay high out-of-pocket costs.
“The current pricing of the medications makes them inaccessible to all but a small proportion of people while they’re not subsidised by the PBS,” Dr Sumithran said.
However, as Dr Deed pointed out, economically, it would be a difficult proposition.
“Two-thirds of adult Australians are overweight or obese, an immense number. So getting a clear pathway to subsidisation may require some restricted access to some groups of people with obesity, to make the dollars balance up,” he said.
As InSight+ reported in June, the Pharmaceutical Benefits Advisory Committee considered semaglutide for obesity at its March 2022 meeting. However, it decided not to recommend the requested listing as doing so would have required “extremely high investment” with “very uncertain implications for the PBS and broader health budget,” the committee said.
Unfortunately, there are no easy answers, and with insufficient stock for both obesity and diabetes patients, there will be many months of uncertainty ahead.
“Every day, I have had to advise patients with changes to their treatment because of these shortages (and others). It adds time to choose different approaches and explain the choices and update the patients on specific aspects of risks and side effects with the changes. All of this causes distress and patient concern,” Dr Deed concluded.
For guidance and information, visit:
- RACGP – Management of type 2 diabetes: a handbook for general practice
- Australian Diabetes Society resources
- TGA – Ozempic (semaglutide) shortage
Caitlin Wright is a Sydney-based freelance journalist and 2022 Copywriter of the Year who writes for communities and organisations that care for others.
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I am guilty of taking it for weight loss. I was 57 kilos all of my life then at 45 menopause came along, 47 Hashimotos. I gained exactly 50 kilos. Next I was diagnosed with Emphysema. Losing 27 kilos on Ozempic improved my breathlessness about 90%. My arthritis pain wasn’t so bad, my knees weren’t aching much, my legs weren’t in pain, my blood pressure went down, cholesterol lowered. So many people here aren’t on it to ‘fit into a size 8’ like I used to, it’s making so many peoples other health problems improve. I have learned a lot by gaining so much weight, gain is not always just ‘what is shovelled in the mouth’, so many health conditions cause weight gain and the weight gain causes so many more problems. I haven’t left the house since gaining 10 kilos back and it’s not about a big belly or between the legs rubbing, it’s because I get out of breath just moving. I totally believe the people that know this is all about the money. That is what the world has become and Australia are up there with the greediest. I am considering using my Super to have surgery as I am on the dole do to so many health and mental health problems. I read an article that Novo made so much money that they are building three new plants to keep up with supply of just Ozempic. Australia definitely don’t care enough to make any weight loss products reasonably priced, that wouldn’t fill their pockets. Good luck everyone, I hope matters improve.
I think it should be on a case by case basis.
By putting an authority on it for people with diabetes who can’t use any other medication, and for people struggling with obesity with a minimum BMI and comorbidities.
I have always struggled with my weight. I have multiple health issues that increase weight gain (thyroid disease, PCOS, meds to make a few)
And I have multiple health issues caused by weight gain (sleep apnea, liver disease, poor circulation in legs)
Unlike for diabetes, there are very few medications for obesity. Metformin made me violently sick, saxenda and contrave is way too $$$ and duromine is incredibly risky.
Diet and exercise has never helped me lose weight, and being on disability pension there is absolutely no way I could afford weight loss surgery.
Ozempic was the only suitable option, until shortages.
No one’s health is more valuable than the next person’s. Having a case by case strategy means everyone can access their necessary medication
The sooner other makers of this drug come on the market the better ,then everyone can use it to treat their problems ,I have used Ozempic when I can get it and have lost 20 Kg . I had a blood pressure problem that since has eased and was going close to being Glucose intolerant,so in my opinion we all need the treatment and one group shouldn’t be prioritised,Maybe the sender is supply ,is Norva Disk just prioritising places where they can get more money for the product ,and why isn’t there other companies making it so there isn’t a supply problem
Not the fault of a drug company that stands to make $1200 a script in the USA and only $138 in Oz. I wonder if the shortage is a deliberate scheme so that the government rushes into the 2.4mg version called Wegovy.
The only hope is other GLP-1 will come on the market and flatten the market.
I suggest anyone needing ozempic and prepared to pay $150 contact your nearest compounding pharmacy.
Thought capitalism meant no shortages. Guess not, unless you are healthy and rich.
Stop blaming other patients and pressure politicians to do something about the pharmaceutical companies.
I have been without ozempic for at least 6 weeks (I have a part of pen left and am only taking a partial dose every other week. I am a diabetic. This medicine was made for type 2 diabetics. We should be a priority, plain and simple.
If you have a condition other than obesity, such as type 2 diabetes, insulin resistance, NAFLD/NASH, or another diagnosed condition that affects the endocrine and metabolic systems or vital organs, then you should be prioritized for Ozempic. If you are obese, even morbidly so, but do not have any other diagnosed comorbidities, then you should not receive priority. As someone with NASH, autoimmune liver disease, and type 2 diabetes triggered by a steroid to treat inflammation of my liver, but who lost 70 lbs through diet and exercise before ever starting Ozempic, and and additional 30 lbs after, I have a lot of difficulty sympathizing with people who are not putting in the effort to make real diet and lifestyle changes. No drug will help you lose the weight and keep it off if you aren’t willing to put forth the work dnd effort need to maintain a healthy lifestyle. Ozempic doesn’t help you lose that much weight anyway. On average it’s about 12 lbs a year. I have continued to diet and exercise. I make it a priority despite a busy schedule and speak with a registered dietitian to gain education about food choices.
For diabetics poor control may make you lose vision or have heart attack or stroke. NO COMPARISON WITH SLIMMERS. Disgraceful beyond words that diabetics who need a drug to stay alive and not blind are left without the medicine they desperately need ,. Nothing at all has been done to prevent this happening again and again which is beyond belief in a civilised society. I have written to health ministers State and Federall. Nothing. I have already lost vision permanently after 10 years of stability. I am furious.
I am 79 years old. Type 2 diabetic. Ozempic helped me lose 20k in 6 months. Then I developed gallstones.
Ozempic was stopped in June. Gallbladder removed in November. Now when I want to go back on Ozempic, I cannot get it. Ideas anyone?
I’m type 2 for the first time in 6 years I’ve been able to get shoes on my feet after starting on Ozempic and I feel like I’m in the land of the living again until the shortage. The reason it’s low on stock is because Hollywood stars have come out and said they use it for quick weight loss and yes it’s all over social media so the company which makes it in the U.S. can’t keep up..hears a thought .. when is Australia going to step up and start producing medications that is in short demand..we have the means to do so and think of the money we could make selling it to other countries. Also the Gastric sleeve op should be available in the public system to those who are serious about it. You can move to NZ for 6 months and get it for free yet our own country refuses and who has $20,000+ to pay private. We have a real issue here both with Type 2 and Obesity.. I’ve put on 30+kgs due to having breast cancer and the meds I had to take to save my life now I’m left with both type 2 and Obesity.
Starting to feel like it was a waist of time surviving because I can’t lose the weight to get my reconstruction and feel like I’ve been mutilated and forgotten. I didn’t choose to be over weight and sick all the time.
I have diabetes but ozempic hates me and I feel like death and no amount of weight loss could compensate for feeling like life wasn’t worth living
My daughter thought I was seriously ill and not telling her!
Yes I lost weight but i didn’t eat , I couldn’t keep anything down , when I could I would have rice, watermelon, boiled potatoes, usually they would come back depending what stage of the 7 day cycle I was in
I’ve has severe asthma for over 20 years and have been given huge amounts of corticosteroids and the sygars go up and the weight goes on so I don’t disagree with it being used for weightloss but until it’s freely available maybe just obesity with other factors such as corticosteroid treatment, heart conditions etc
I’m a larger woman I’ve lost 70 kg over time my sugers are close to 30 at most times ozempic has brought my levils down to 8 and it is an amazing feeling and knowing that I have a chance at life with less pain . Less loss of eye site .. my liver is almost destroyed. Ozempic has helped me have a better quality of life . Now I’m afraid ,I cannot get it and now I’m struggling to get trulicity ..☹️.. I think it should be prescribed for people like myself until it’s readily available for everyone. I don’t want to die I’m too young . Insulin does not wantork on me …
Obesity is a disease that can NOT be simply fixed with diet and exercise. And obesity has arguably MORE complications than diabetes. There are also many other medications that are just as effective as Ozempic for diabetes, but there are NO other medications that induce weight loss the way Ozempic does. Given this, I would argue that if any patient group were to take priority, it should be those with obesity. But my personal belief is that no patient group should take priority over another, ALL are important. And why isn’t the manufacturer ramping up production? Thats the real question here. Why is there a shortage to begin with?
I have a pituitary tumour and due to that gained a huge amount of weight. Two hours of hard exercise daily (2 group exercise glasses daily) and eating less than 1000 cals a day did NOTHING to promote weight loss, it’s a hormonal problem. With Ozempic I lost 22 kgs and was able to start eating normally again. Now that I can’t have it anymore, I’ve gained 8kgs back and my health is deteriorating. This is NOT just for diabetics, it’s for anyone with a medical need, and my need is just as important as anyone else’s, be they diabetic or obese or any other indication. I wish people would educate themselves before they spout off opinions like ‘obesity can be cured with diet and exercise’. For some people, it can NOT. How very ignorant and insensitive to broadcast such an outdated view. Hope you one day develop a disease that causes you to gain 20kg and see how you feel then. Especially when you finally find a cure, but its being withheld.
No one person is more important than the next. And this is not the actual medicine for those with diabetes that is what insulin is for this is meant to go with the insulin and can possible help there is no guarantee. That being said that still does not mean that one group is more important than the other. I saw a comment that said “with diet and exercise obesity can be fixed”. Obviously you have never struggled with obesity. I have for the last 25 years and it has been a frigging roller coaster to hell and back filled with a lost of depression. NO its not so easy wit diet and exercise. Oh and did you know a side effect to obesity is DIABETES!!!! You have people that are overweight getting their stomachs butchered just to get some help. And here you have a medicine that helps both those with type 2 diabetes and those that are obese but you want to shame those that are obese for trying to do something right to get the weight off but also shame them at the same time when they are obese! This world is a joke. We don’t help people anymore we watch them fall down and we laugh at them. We don’t help them up, we find a way to make them feel worse. People need to stop being so rude and hateful and realize that both diabetics and obese people need this drug and it needs to be accessible and affordable to both of them. And as for the drug company they need to figure the hell out how to make the supply match the demand. They are dang well making enough money off of it to insure such!!!! People don’t use saxenda or wegovy in most cases because their insurance will not cover it. In my case my insurance won’t cover anything that will help me lose weight, crock of crap consider what I pay a month for it. Stop with the shaming and stop making others more important than those with obesity because NEW FLASH obesity kills just like Diabetes and contrary to some peoples belief it is not as easy as just doing some diet and exercise to not be obese…. Ozempic has shown OUTSTANDING results in weight loss with microscopic side effects. AMERICA people are losing weight and getting healthy another NEW FLASH when that happens it has the potential to drive down the cost of healthcare!
I an nearly 75 and was previously injecting insulin 25 mml twice a day, have been injecting Ozempic for nearly 2 years for type 2 diabetes, in that time I have gone from 12kg to 90 kg, fortunately I have been able to access sufficient supply to maintain my blood sugar levels in Perth Western Australia
Drug company can easily increase production to meet demand. But they are purposefully keeping the supply low because they realised that they could make more money by selling same drug but different name with TGA approval specifically for obesity (Wegovy). They are missing out on huge profit by letting obese people using Ozempic for weight loss. Both are semaglutide. but Ozempic is TGA approved for diabetes only and been used off label for obesity. They have been waiting for TGA approval for Wegovy, and then will start supply again and make lots of money. Stop blaming doctors and people with obesity. Go ask the drug company.
I used ozmepic for weight loss as my health problems restricted me from doing any physical activity and although I tried dieting it just wasn’t working. Ozmepic was working, but due to the shortages I had to stop, so I went on saxenda. Thus is extremely more expensive but it does work, but sometimes it’s still hard to get and you have to inject yourself every night and my stomach gets very bruised from this. But my Dr has said once ozmepic is readily available again, she will put me back on that, and it’s much better than getting gastric bypass surgery
Purely personal perspective, not being able to get trulicity for t2d has forced me to research options, after 2 and half weeks on one of those i am no longer on any meds ie Metformin ect. and feel the best.i have in along time, nice to have energy again. I m not thankful for the situation for other people just from the point it gave me a shove to not accept the status quo of standard treatment ita.not always right and is in flux.,
Quoting the quote
“The TGA does not have the power to regulate the clinical decisions of health professionals and is unable to prevent doctors from using their clinical judgement to prescribe Ozempic for other health conditions.”
There hasn’t been any trouble with the TGA regulating medications over the past couple of years. Can our government not pressure the manufacturers to supply Australia or is it the typical attitude of Australia is just being the dumping ground for medications deemed unsafe elsewhere in the world and have no priority for new effective medications.
I have struggled with obesity all my life and on Doctors advice was prescribed ozempic. For the first time in a very long time I was given some hope. I found that ozempic was really helping me get my hunger under control. But unfortunately after two months and 8kgs lost I was told by chemist that I was no longer able to get it as it was being saved for people with diabetics. I believe that this is unfair as we are all equally in need of this medication and it should be available to all who Doctors recommend it to. I look forward to the day when it is available to all of us who need it.
What interests me is that , though it has been a great diabetes treatment for me – why hasn’t it caused me to lose any weight? And I agree with other posters, why can the pharmaceutical company not make more, quickly?
Obesity, while uncomfortable, can be managed with exercise and diet… diabetes can’t and has significant long term medical complications if poorly managed. Until supply can be stabilised it should be limited only to it’s intended patients… diabetics.
I was using Ozempic for weightloss prior to the shortages and moved to Saxenda when the supply problems began.
I was very accepting of supply priority going to Diabetic people at the beginning, I felt that my issues could wait as they were in immediate need. But now I feel victimised by the media.
I did not start using Ozempic because of something on Tiktok or Youtube. I started because my doctor assessed me, my situation and the results of all my other attempts to loose weight for the last 30 years.
Not only is it a huge financial commitment for those using it off script, it still requires the time, commitment, strength and discipline of diet and exercise to work. It is by no means a quick fix. I’m only maintaining my weight while I’m on Saxenda, I desperately waiting for more stock so I can start (very slowly) lossing again.
The real question is why demand was not predicted by Novo Nordisk, why isn’t there something in place to stop companies not providing enough of a drug that is life saving. This isn’t unique to this drug and it’s only “news worthy” because it’s great clickbait
Also type 2 diabetic on meds and trulicity for about 6 years and haven’t been able to get in for over 5 months and not sure when it’s back in stock
I have been a diabetic for 35 years I have tried all oral and injectable that my doctor has known. Lantus my insulin puts on weight since restarting it have put on 40kgs without changing my exercise eating routine. Then came Olympic, 1st time ever blood sugar dropped to 5 to 6, I felt incredible. More energy, no thirst amazing! Now I can not get it!
My kidneys are now causing problems my levels 10 to 14, tired and thristy. Been not taking drug for 3 months and chemists saying New Year before stocks return.
Yes drug needs to be priorised. For some of us like me it’s life or my kidneys fail. That’s the fact I am facing.
My partner suffers from Type 2 diabetes & obesity. Ozempic was working to control both her blood sugar & also with weight loss. When it became unavailable in the long term she was prescribed Trulicity which then became unavailable in the long term. Now she has had to restart Gliclazide & also start Insulin to help control her sugar levels. It’s a disgrace that in this day & age lifestyle choices are sometimes prioritised over immediate medical needs.
Why not prioritize by medical necessity? If these drugs play a vital role in keeping one alive, then it would make sense to prioritize that patient over one who may be taking them for preventative or vanity reasons.
I find it bizarre that the world pharmaceutical companies can research, create , trial , and produce enough covid shots to treat 8 billion people many times over in less than 6 months , but we cant produce enough semaglutide to fix less than 5 percent of the world population , considering that these semaglutide drugs have been approved for years ,,all the pharmaceutical companies need to do is ramp up production . How hard can it be ????
How about a REALISTIC option?
The only remaining non- insulin injectable, liraglutide currently costs ALL users $400 per month.
Why isn’t this being temporarily NHS listed until at least one of the others are once more readily available?
I am 63 yrs old and have several health issues . Through my endocrinologist I have been under a dietician for over 18 mths. Before all the publicity on shortages I was prescribed Ozempic. I have lost 24 kgs since Christmas something I was unable to do despite strong will, a dieticians directions and adjustments to my thyroxine and other medications. My BMI has reduced substantially, my high Cholesterol has reduced to an almost average amount, my thyroid levels are good and my glucose test came back good too which is fantastic when your immune system doesn’t ok properly. The healthier I am h best chanc I have to fight sickness. While I understand diabetics being cross, sad and anxious about the current dilemma I don’t think one life/ health situation is more important than another. My health is the best it has been in years despite my strong will and dedication to getting healthy. I didn’t do this by choice but on recommendation from my Doctors. Finger pointing doesn’t help any of us . Be kind everyone and I’m sure things will ease and we will all benefit.
How is it a “hard call to objectively place preferences over one group of patients” when one group losing access is actually life threatening and the other group isn’t? Seems like a fairly basic triage to me
I have type 2 diabetes. Nothing would control it, despite oral meds and Humalog insulin. Eating very small meals in certain time slots. Exercising. I have other health problems as well.
But only being put on Trulicity has controlled my blood sugar levels. It has worked really well for over 4 years. But when suddenly I was told I can’t get it any more. I was put on Byetta instead. This has not worked at all. Instead I have had to keep increasing Humalog insulin higher and higher. It still isn’t controlling it.
Also associated problems with diabetes keep happening now as well.
For people with diabetes that will only be controlled by Trulicity and other Ozempic drugs. This is not just an inconvenience but is life threatening.
Obesity has many different drugs and approaches. But diabetes with complications only has a few. So it feels very unfair and frightening to have it taken away suddenly with very little idea of when if ever it will be available again.
I am a type2 diabetic on trulicity,metformin and Jardiance . If I can’t get Trulicity I will start on Trajenta. There is a new injection coming that has passed 2 nd phase in the USA. When it passes trials in Australia I will switch to it. Unreliable medicine supply is not a problem for the obese person in the short term, but is for type2 particularly with cardiac and renal problems. If the hype on the new drugs are true then early use of these injections in type2, obesity and pre-diabetics will be the norm provided side effects (pancreatitis, gall stones and intestinal problems) are corrected.
I’m diabetic and I use ozempic and without it my blood sugars go thru the roof and I struggle with my sugars. When I’m on it, things couldn’t be better and I’m energetic. My three monthly blood test was just completed and being on it, I came down from 11.9 to 6.9. The first time my doctor has been happy with my bloods in a long time. So to me, diabetes patients need this drug over usage for weight loss. By all means, if there was enough to go around, I’d want everyone who need it to use it.
Ozempic is the only medication that actually controls my diabetes. As well as not tolerating any tablet form of medication. Should never been prescribed off list for obesity. Now whe I can’t get this I’m back to being super sick and it’s puts me in a dangerous situation. Very very stressful and angry.
It’s a hard one to justify prioritising subsidised Ozempic just to Diabetics.
Each individual case needs to be assessed and prioritised for their need.
Yes number of obese people is very high, but some people are benefiting from some of the other by product side effects of Ozempic. For example, improving liver function in some individuals.
I am T2DM on orals and insulin. Prior to Ozempic I managed to lose 17kgs over a 12 month period. Since starting Ozempic in March I have managed to lose another 16kgs. It has made a massive difference to my life as I also have other health issues associated with the diabetes. I only hope and wish this shortage ends real soon and all that need Ozempic can be treated accordingly.
Can’t put a price on health!