‘Entrepreneurial GP’ weight loss services blamed for GLP-1 RA shortage

Medicines

By Geir O'Rourke

18 May 2022

A national shortage of semaglutide (Ozempic) is expected to continue for at least another month amid reports of a boom in off-label prescribing for weight loss.

The GLP-1 receptor agonist is currently indicated for the treatment of adults with type 2 diabetes but supply has been inconsistent over recent weeks, with pharmacists being advised back in April to limit dispensing to a month’s supply at a time.

Pharmacy Guild of Australia president Professor Trent Twomey told radio station 2GB there had been a rise in prescriptions by online weight loss clinics to patients wanting the drug as a hunger suppressant.

“These entrepreneurial GPs are popping up with apps that are issuing a script without them ever seeing a patient,” he said earlier this month.

“There’s nothing illegal about it but it’s a bit immoral and this is what is driving up demand.”

The TGA said it was aware of the rise in off-label use but was expecting regular supply to return on 15 June.

It added there were currently no plans to place restrictions on off-label prescribing through the Poisons Standard like those placed on ivermectin a year ago.

“The TGA is monitoring the outcome of informing healthcare practitioners about shortages of Ozempic and  other measures before determining whether restrictions on off-label prescribing are warranted,” it said.

The AMA described the shortages as significant and urged pharmacists to ensure supply was available for patients with type 2 diabetes.

“GPs may wish to encourage their patients to renew scripts early to ensure supply,” it added in an update last week.

The drug’s supplier Novo Nordisk markets semaglutide as a weight loss treatment internationally under the brand in Wegovy, which has also been a huge overseas sales success, but  currently only liraglutide is registered with a weight loss indication with the TGA.

An application for PBS listing of semaglutide for weight loss was rejected by the Pharmaceutical Benefits Advisory Committee at the end of March, despite trial data showing semaglutide plus diet and exercise was superior to diet and exercise alone for weight loss.

“These benefits were only demonstrated over the short term and whilst on treatment, and it was unlikely they would be fully realised in Australian practice without the intensive diet and exercise counselling co-administered in the trial program,” the PBAC said.

“Moreover, the submission’s modelled reduction in comorbidities over a lifetime was highly uncertain given that no longer term data was presented.”

On top of that, the proposed listing would likely cost above $1 billion on average over six years, with “very uncertain implications for the PBS and broader health budget”, the committee said.

Novo Nordisk said it was “experiencing strong demand for Ozempic (semaglutide) that may result in intermittent availability at pharmacy”.

“We continue to receive supply into Australia regularly, and we manage stock closely to ensure it is distributed as quickly as possible.”

“Our priority is to ensure people living with type 2 diabetes are able to access Ozempic (semaglutide) and we are taking actions towards continued stable supply.”

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