Diabetic medication should be for diabetics – this was a plea the European Medicines Agency felt compelled to make in March, when it urged doctors to prioritise life-saving treatments for those who depend on them.
It came on the heels of similar statements made previously by authorities in France and Australia, signalling the emergence of a global shortage of vital diabetic medication. And as with many modern trends, the sudden surge in demand had its roots in social media.
Influencers have been singing the praises of drugs such as Ozempic, Wegovy and Trulicity for rapid and significant weight loss, even recommending them to followers as a diet hack. On Twitter, Elon Musk declared Wegovy helped him lose 13.6kg. While other celebrities have refused to confirm whether they have used them – including Kim Kardashian following her sudden weight change in preparation for the 2022 Met Gala – fans the world over rushed to get hold of these ‘wonder diet drugs’, inadvertently draining supplies and putting diabetic people at risk.
What is antidiabetic medicine?
Ozempic comes in a pre-filled injection pen. It contains the active ingredient semaglutide, a synthetic hormone used to manage Type 2 diabetes and thereby support those at risk of heart attack, stroke and other weight-related illnesses. While Ozempic’s indicated use is to increase insulin sensitivity and stop glucose conversion into fat, it also suppresses the appetite and makes the user feel full quickly, thereby lowering calorie intake and aiding weight loss. These side effects led to the development of sister brand Wegovy, using the same drug but at far higher doses, specifically targeted at obesity rather than diabetes.
Following celebrity praise and a successful diet marketing campaign, popularity exploded across the US, Australia, and recently in the UK where doctors prescribe the drugs off-list to non-diabetics willing to pay high prices. With Wegovy soon to be sold over the counter in Boots stores in the UK, the demand is likely to rise further. Ozempic and Wegovy are both made by Danish firm Novo Norodisk, which holds the patent for semaglutide and is the only firm with FDA approval to sell it under brand names. Enormous demand soon collided with production problems, as Norodisk’s pen-filling supplier in the US hit fulfilment problems. Depleting stocks stoked competition between private payers and medical patients, and ultimately resulted in the latter having their medication rationed.
Is supply the problem?
While manufacturers could increase production to serve the dual markets, as with all drug management, this will take time, and Bloomberg reported that Norodisk has only recently recovered supplies in the US. More worryingly, the situation indicates a rise in turning patient care into luxury health services, with a similar example being that of continuous glucose monitors (CGM).
CGMs are wearable sensors attached to the skin that constantly track blood sugar levels and alert users to changes so they can better manage the highs or lows. They represent the frontline of Type 1 diabetic care, enabling detailed glucose control, essential for safe pregnancy and reducing the risks of medical issues such as loss of sight in later life. According to UK drugs pricing regulator NICE, CGMs have the potential to revolutionise diabetic self care and should be available to all children and vulnerable people, but they are expensive and not all diabetics can afford them or get access to them via the NHS or insurance plans.
More recently the sensors have started being advertised as personal health trackers for the general public, mostly fitness fans, to gain a more detailed view of their stats, despite Harvard University research suggesting they offer little if any value to those not at risk of developing conditions. But what is clear is that the more people take up CGMs and weight loss injections, the greater the pressure on the few manufacturers, and the risk that life-dependent users will be squeezed out over profits.