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Weight-loss drugs: Like bracelets on the market, people with diabetes pay the price

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The drug Jeremy Mitchell takes to manage his diabetes, Ozempic, has become a new weight loss fad, and now he’s having a hard time finding it.

Mitchell, 39, of El Dorado, Kansas, was diagnosed with type 2 diabetes in 2020.

He runs in his family. Her father, a double amputee, died last month aged 62 from complications of diabetes.

“It’s about me,” Mitchell said. “I have three kids that I want to see grow up, and I want to see my grandkids grow up, and for me, Ozempic has helped me manage my blood sugar.”

Jeremy Mitchell and his family

When Mitchell was diagnosed, his A1C – a long-term measure of blood sugar control – was peaking at 10%.

After learning he had diabetes, he lost about 50 pounds through diet and exercise. But when he took a less active job, he found he couldn’t keep it up. Some of the weight has taken over.

In May, his doctor put him on Ozempic, which helped him lose about 20 pounds. His A1C dropped to 6.8%. This is still within the diabetic range but much closer to normal, which is below 5.7%.

When Mitchell recently picked up his refill, an automated message told him there would be a delay in picking up his standard 1-milligram pen due to a nationwide shortage. The three other pharmacies in town all told him the same thing: they no longer had this dosage.

He was able to get his doctor to write a prescription for a lower dose, but that means he will have to double the injections. It also confused her insurance company, which initially refused to pay for the drugs. The pharmacy then said he would have to shell out $1,000 to buy a two-week supply. His co-pay is normally $5.

After negotiating with the insurance company, Mitchell was able to cover the pen, but since he doubles shots, they will last him half as long as usual.

He doesn’t know what will happen when that pen runs out. He fears having to plead his case again with his insurance company.

It all meant working extra hours to get what should have been a routine medication refill. Mitchell wanted to know why he suddenly had to jump through so many other hoops, and an internet search turned up stories of celebrities using the drug to lose weight. Mitchell was furious.

“My goal at 39 is to try to delay insulin addiction as much as possible. I don’t want to suffer the same fate as my father,” he said.

“I guess I’m just mad not just at celebrities but anyone who would use this, and especially knowing there’s a shortage. That information came out,” he said.

Every winter, millions of Americans end the year with tighter belts, leading to another annual ritual: the New Year’s promise to lose weight.

Nearly one in four Americans have promised to live healthier lives in 2022, making it number 1. 1 New Year’s Resolution. 1 in 5 people say they want to lose weight, according to consumer data website Statista.com.

Despite these good intentions, the weight continues to pile on. More than 2 in 5 Americans were classified as obese, with a BMI over 30, between 2017 and 2020, according to the US Centers for Disease Control and Prevention – up more than 10% from 1999-2000 .

Until recently, people struggling to lose weight had only limited help from their medicine cabinet.

three pills Approved by the United States Food and Drug Administration, it has caused an average weight loss of approximately 5% to 10% of total body weight in clinical trials.

In 2014, Saxenda, or liraglutide, entered a new era. Taken as a daily injection, it became the first in a class of drugs developed to treat diabetes to gain FDA approval for weight loss.

It belongs to a family of relatively new drugs that mimic the effects of an appetite-regulating hormone called GLP-1. These drugs work by stimulating the release of insulin, which helps lower blood sugar. They also slow down the passage of food through the intestine.

“It leaves you feeling full almost all the time,” Mitchell said of the GLP-1 agonist he takes, Ozempic. “You don’t want to eat.”

Ozempic, or semaglutide, is the more potent cousin of liraglutide. Instead of a daily injection, semaglutide is given once a week. The FDA approved it for diabetes management in 2017 under the brand name Ozempic and for weight loss under the name Wegovy in 2021.

Wegovy became a runaway success, fueled by celebrity endorsements and social media posts showing remarkable transformations before and after. On Twitter, Elon Musk credited Wegovy for her recent weight loss.

Studies suggest that the drug can help people lose an average of 10-15% of their starting weight – a significantly greater amount than with previous drugs.

But soon after Novo Nordisk began marketing Wegovy, it went into short supply when a Brussels-based company contracted to fill the syringes was cited by the FDA for quality issues. Manufacturing of the drug has come to a halt, and shortages that were expected to be resolved this year have continued.

Wegovy should be taken both to lose weight and to maintain it. Studies show that once people stop using it, any lost pounds can be regained.

“There were a number of patients starting Wegovy who couldn’t continue,” said Dr. Kimberly Gudzune, medical director for the American Board of Obesity Medicine.

“And so because of the kind of inability to get Wegovy, many doctors started prescribing Ozempic off-label, which they’re licensed to do, for the treatment of obesity,” she said. .

As a result, many of these GLP-1-mimicking injectable drugs are now in short supply.

Besides Ozempic, the FDA lists Eli Lilly’s Mounjaro, or tirzepatide, as being in short supply, as well as some strengths the drug Trulicity, or dulaglutide.

“It’s really snowballed,” Gudzune said, and people with diabetes like Jeremy Mitchell are now struggling to find their medication.

Gudzune – who also treats people with diabetes – said the shortage has changed her practice. She sent prescriptions to pharmacies electronically, which is fast and reduces errors. But she can’t do that for those injectables anymore.

“We kind of, as a group, had to go back to giving people paper prescriptions because then they can call and bring it to the pharmacy at the pharmacy at the pharmacy so they can find places that actually have medication that can be dispensed,” she said.

Gudzune said the shortages are especially hard on low-income people who don’t necessarily have the means or the time to visit or call a bunch of pharmacies to find their medicine.

Novo Nordisk, which manufactures both Ozempic and Wegovy, said in a statement that it was experiencing intermittent supply disruptions of certain doses of Ozempic “due to a combination of incredible demand coupled with supply constraints. ‘global global supplies’.

While it acknowledges that some health care providers may prescribe Ozempic off-label to people who wish to lose weight, the company “does not promote, suggest, or encourage the off-label use of our medications.”

As for Wegovy, Novo Nordisk said it has taken steps to increase production. It plans to add a second contract manufacturing organization in the first half of 2023. Its current syringe filler has restarted production and plans to add a second site later in the year.

Novo Nordisk said it is on track to have all doses of Wegovy available by the end of the year.

“We are asking healthcare providers to hold new patient initiation on Wegovy until we confirm broader availability at the pharmacy level,” wrote Nicole Araujo, senior manager of corporate communications, in an email.

Gudzune said she follows that advice. When people ask about weight loss drugs, she tells them to wait to start taking them until the tension subsides.

“The excitement around these drugs is, right now, a bit of a double-edged sword. I’m glad people are excited and feel like they have a treatment option for their obesity that would be really meaningful.” , she said.

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