May 16, 2024 - Health

Weight-loss drug shortages have patients stressed over missing doses

Illustration of a silhouette of a person with tangled measuring tape in the shape of a brain

Illustration: Sarah Grillo/Axios

Patients prescribed highly effective anti-obesity medications are growing anxious about the increasing difficulty of obtaining them amid long-running shortages driven by blockbuster demand for the drugs.

Why it matters: Their ongoing struggle to locate reliable supplies of drugs like Novo Nordisk's Wegovy is fueling fears among patients that even a brief disruption to their dosing schedule could set back their progress, doctors who prescribe the drugs told Axios.

  • "They ran out of stock everywhere about a month ago. It went from being pretty easy to locate to being pretty tricky," said Ethan Lazarus, a board-certified family medicine and obesity doctor in Denver, who dubbed the phenomenon "GLP-1 discontinuation anxiety."
  • Lazarus and other doctors Axios spoke with said nearly all of their patients in recent weeks have run into trouble finding their prescribed dosage.

State of play: For months, versions of Wegovy and Eli Lilly's Zepbound, which both belong to a class of drugs known as GLP-1 agonists, have been in shortage as already high demand takes off.

  • For instance, Novo says at least 25,000 U.S. patients are starting on Wegovy every week, roughly four times the number from December.
  • Patients are frantically calling pharmacies to track down their prescriptions, and in many cases, having to switch dosages or drugs altogether.

For some patients, one of the most distressing aspects is how quickly persistent thoughts about food return.

  • On GLPs, that "food noise" goes away "and they feel so free," said Christine Ren-Fielding, director of NYU Langone's Weight Management Program.
  • But when they can't find the prescription, "They're freaking out because now they're going back into prison with this distraction, and it's terrifying," she said.
  • Meanwhile, doctors said some patients are also having a tougher time getting insurers to reauthorize coverage of their prescriptions after many tightened rules at the start of the year to limit spending on the pricey drugs.

Between the lines: Experts say going off the drugs, even for a week or two, can be disruptive.

  • Patients start at lower doses before gradually increasing to higher doses, a process that usually takes months.
  • In some case, patients who've been ratcheting up their doses over months may have to go back down when they resume their prescriptions, Lazarus said.
  • "It's really tough when you finally find something that's effective and you get discontinued on it," he said.

Doctors may recommend switching Wegovy patients to Ozempic, the diabetes treatment with the same active ingredient. But insurers likely won't cover Ozempic for weight loss.

  • Or they could switch patients to a different brand of GLP-1, but that raises the risk of patients experiencing nausea.
  • "At that point, the patient is so desperate that they'll try it," Ren-Fielding said.

What they're saying: The head of Lilly's diabetes and obesity division, Patrik Jonsson, said the company is "doing everything we can" to avoid disruptions for patients.

  • "We fully understand the frustration at the patient level when you find a game-changing medicine, and then suddenly you have difficulties in finding the supplies," Jonsson said.

What we're watching: Novo and Lilly are spending billions to ramp up production of their GLP-1s.

  • Both companies, as well as would-be competitors, are also developing oral versions of anti-obesity drugs that would be easier to manufacture in larger quantities than the current injectables.
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