Glass Not Full

Are Semaglutide Supply Shortages Over?

This is a story that’s been on repeat for well over a year. Novo Nordisk announced its business results for the full year of 2022 this week and declared that supply issues with Wegovy are over – almost. But the fact is that it’s not at all clear that the problem of supply shortages for semaglutide (the active ingredient in Wegovy) are really over.

Yes, all strengths of semaglutide under the brand name of Wegovy are once again, more or less, available nationwide. But the company cautions that pharmacies may encounter occasional hiccups with getting their supply. In addition, the same drug under the Ozempic brand name remains in short supply. The company says the “supply of Ozempic cannot keep up with demand in some markets.”

The FDA doesn’t equivocate in its listing of drug shortages. Both Ozempic and Wegovy are in short supply. So, too, are Mounjaro and Trulicity – two other drugs that work on the same metabolic pathway where semaglutide does. Those two drugs come from a different company, Eli Lilly.

Off-Label Pish Posh

A popular explanation in the media is that off-label use of Ozempic for “weight loss” explains the supply shortage of semaglutide. This story line, even if it seems to be great clickbait, isn’t very compelling. Answering a question about blaming misuse for the shortages, we explained to People magazine that we think it’s a mistake:

“We do not know for sure, but something that we do know is that 73% of the population has either overweight or obesity, and 43% of the population is in the range of obesity itself. And so just as a matter of odds … every other person you meet, more or less, is going to in fact be medically qualified as having obesity.

“All of these glib statements about rampant misuse are not based upon any kind of informed interaction with individuals who know their health in consultation with their doctor.”

The Branding Shell Game

The story gets more convoluted when you factor in the mishmash of brands and pricing for different forms of semaglutide. While the Wegovy brand was in short supply, people who needed semaglutide for obesity had the option of the same drug (at a lower dose) under the brand of Ozempic. Add to that the fact that Ozempic (for diabetes) is quite a bit cheaper than Wegovy.

But the fact is that it’s all semaglutide and Novo Nordisk is not yet making enough of it to meet the worldwide demand for both diabetes or obesity.

Obesity or Weight Loss?

The final piece of this mess is the whole question of whether people are using this for the right reasons. Are people just trying to lose weight? Or are they trying to treat the chronic disease of obesity? These questions surface because of the subject at hand – obesity – and all the biased, fuzzy thinking that comes with it. Weirdly, and unlike any other chronic disease, it seems necessary to judge the people who are trying to cope with it.

So it’s convenient to blame them for the supply shortage of semaglutide. But it’s not right. The real problem is simply that supply is not keeping up with the medical need.

Click here and here for more on recent comments from Novo Nordisk on this situation and here for our interview with People magazine.

Glass Not Full, photograph by lost places, licensed under CC BY 2.0

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February 3, 2023