We are back. Happy 2023! I hope you had a wonderful holiday season and are ready for some new content!

This is one of my first articles back, and needless to say I am excited for it. We’re gonna be getting back into all the juicy, wonderful content and various topics that we typically cover – weight-loss drugs, obesity and everything in between. 

So to kick things off, I wanted to do a bit of a dive into the shortage of Ozempic and Wegovy. What’s going on, and why are things shorted? We’ll discuss some alternatives, things you can potentially do, and when the shortage might be resolved. 

So let’s get into it!

What is and why do drug shortages happen? 

Drug shortages aren’t a new thing; they happen all the time. Although some of my more seasoned pharmacist friends have pointed out that, at one point, drug shortages weren’t actually a thing. Being a less seasoned pharmacist, graduating in 2016, I sometimes reflect on what things might have been like during that era. Unfortunately, for my generation and since the pandemic, things have gotten substantially worse. 

Something as important as medications begs the question of why a shortage would ever occur in the first place. One of the major things at present comes down to supply chain issues. 

Like many other products we consume daily, medications must go through a series of steps, or links in a chain, before they make it to the vial sitting in your kitchen cupboard. 

First, raw ingredients must be acquired to manufacture a pure form of the drug, then fillers or other substances need to be added for stability. That product must then be measured out and compressed into tablets or capsules, counted into bottles and shipped to a wholesaler; then, the wholesaler must distribute the bottles to the pharmacy, then, finally, the pharmacist can dispense the medication and hand it to you, the patient, to take home. 

As you can see, a lot goes into the process. If along the way, there is an issue in one of those steps, i.e. unable to get one of the raw ingredients, then the rest of the chain downstream is going to be affected.

Do you remember this poor bastard? He struggled for several days (106 to be exact) and caused all kinds of issues which I believe the world is still trying to catch up on.

As an example, if the Ever Given or any of the other ships needing to make it across the canal are carrying raw ingredients for your medications supply chain, then chaos will ensue when that ship is delayed by 106 days.

Another issue that we have seen occur recently has been recalling due to some drugs being contaminated with unwanted products that could be hazardous to human health. 

Not sure if you remember the Zantac recall? Basically, every single Zantac tablet in existence was pulled from pharmacy shelves as they contained a potential carcinogen. Technically the drug itself, Zantac or ranitidine, is perfectly fine but, when there is a potential carcinogen that got accidentally mixed in – well, that is no bueno. Kinda like finding a hair in your pizza – I mean, sure, that hair is on one slice, and the rest of the large pizza I am eating to myself is likely fine, but how can I know that for sure?

Finally, there can also be a surge in demand, such as what’s happening with Children’s Tylenol and Children’s Advil. The increased demand is because there are a lot more viral infections going around, and kids are getting fevers again. So, parents are going to the pharmacy and getting Children’s Advil and Tylenol. There have been issues with the supply chain aspect; add on the increased demand, and it’s basically a whole rigamarole that leads to a massive shortage. And no, I am sorry, as I have no idea when that shortage will be resolved.

So what about Ozempic and Wegovy? 

I just want to remind you of a quick technicality. Wegovy and Ozempic are the exact same molecule – they are both semaglutide. They just have different names, different pens and different dosages.

Ozempic is used for diabetes management with a dose of 0.25mg up to two milligrams once a week. Wegovy is used for obesity with a dose of up to 2.4 milligrams once per week. Ok, that is it; onwards!

So if you are reading this article, you likely have been struggling to find Ozempic or Wegovy, and you want to know why? Well, it is mostly due to a large and unexpected demand. Plants didn’t have the capacity to keep up, there were issues acquiring enough raw ingredients, and to top it off, one of the manufacturers failed an FDA inspection due to faulty air filters and damaged equipment. Voila, we get a drug shortage.

Everyone, especially Novo Nordisk the manufacturer, were caught off guard by the demand. This demand was driven largely by the media frenzy around the game-changing results that were seen with Wegovy for weight loss – with up to one-third (⅓) of people losing 20% of their weight from baseline. Then the wonderful place that is TikTok had a number of creators jumping on the medication and sharing their results. Celebrities of course, got on board – see Elon Musk. Then everyone wanted to be on it!

Now you might be wondering why is Ozempic also shorted if it is meant for diabetes and not weight-loss? The answer here is that Ozempic and Wegovy again contain the same molecule. So when Wegovy was no longer available, people started to get prescriptions for Ozempic ‘off-label’, meaning they were prescribed the medication despite not having diabetes. There is nothing wrong with this, and clinicians can do it; however, a patient’s drug insurance will likely not provide coverage, so they will be paying out of pocket for the drug. Therefore, we saw a surge in Ozempic prescriptions, and it also became short in supply.

So where are things at now? 

Novo Nordisk has been doing a lot of work in the background and ramping up supply as well as planning for a relaunch of Wegovy in 2023. When that’s expected to happen exactly is unclear and it looks like it varies from country to country.

Australia, for example, has been told by Novo Nordisk that they’re not gonna have Ozempic or Wegovy in place until March of 2023. Previously, Ozempic was the only one of the two that was technically available but now shorted in Australia. 

Canada is in the same boat regarding Wegovy. Wegovy is approved and allowed to be sold here in Canada, but we currently do not have access to it in our pharmacies. As for Ozempic in Canada, as far as I know, we haven’t seen a supply chain shortage as of yet. People can still get the drug and aren’t having any problems in that sense! 

In the United States, it appears that you can’t get Wegovy at all. Ozempic seems to be intermittent, but generally, the supply seems to be keeping up with demand. 

Elsewhere in the world, there are some mixed reports, but hopefully, 2023 brings with it the resolution of all of the above!

So in the meantime, what do we do?

There are a few options. 

First, there are a number of medications on the market currently that are in the same GLP-1 class as Ozempic and Wegovy. In particular, Saxenda which is the only other approved GLP-1 for weight-loss at present. There are drugs such as Trulicity available for diabetes management and could be used off-label for weight-loss, albeit not as effective.

Many people in the US of A have been switching over to a new drug called Mounjaro. Mounjaro is the new kid on the block with some very impressive data that shows it may be more effective than Wegovy and Ozempic for both weight-loss and diabetes management – stay tuned for future articles on this data. Unfortunately, it is not available in other countries yet, and the manufacturer, Eli Lilly, is running into the same issue as Novo with being able to keep up with demand. It is expected that it may become shorted in 2023. Amazing, right?   

Other options for weight management include Contrave or Phentermine. Regardless of your situation, talk to your doctor and see what is possible for your specific situation! 

I wish I could provide you with more information about what is happening and when things will be resolved. But, hopefully, this has provided you with a bit of insight as to what is going on.

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Until next time, you beautiful people. 

Always remember – small tweaks lead to massive peaks.

 Dr. Dan

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