Semaglutide Shortages Abound
Wegovy
Novo Nordisk has announced that they are no longer able to meet the demand in the US marketplace for Wegovy. To ensure people on Wegovy can get their medication, they are prioritizing access to the highest strengths (1.7 mg and 2.4 mg), and will be only producing limited amounts of the starting strengths (.25 mg, .5 mg, and 1.0 mg).
During your dose escalation phase, initiate the fill of the next higher dose 2-3 weeks before you are due to avoid being unable to get the proper dose. We are receiving calls from patients that pharmacies are out of stock on many doses. If your pharmacy can’t get your dose, call around to other pharmacy chains. Also, set up a back-up plan with your provider in the event we need to use a different medication until Novo Nordisk is able to meet the demand.
Further, it will become difficult to start new patients on Wegovy between now and September.
Ozempic
There remains great confusion regarding Ozempic. While many insurance companies offer coverage for Ozempic, this is ONLY if the patient has a diagnosis of type II diabetes.
For people without diabetes wanting to use Ozempic for weight loss, unfortunately, pens here in the US cost around $950 for a pen containing 4 weeks of medication. (With click counting, we can potentially make the pens last 2 months each – discuss with your provider). For this reason, many patients have been ordering their Ozempic from Canadian pharmacies.
Unfortunately, Canadian pharmacies have either stopped accepting new patients from the U.S., and/or are no longer shipping Ozempic to U.S. patients.
Options for Ozempic (as of 5-24-2023):
1) Fill at US Pharmacy: ~$950 / pen (2 mg, 4 mg, or 8 mg) unless being covered by health insurance (only for people with type 2 diabetes). It is possible to use an 8 mg pen to deliver 8 doses of 1 mg, so effectively ~$475 / month.
2) Continue to fill through Canada (if your pharmacy is offering that option).
3) We have found an intermediary that is offering to fill the Ozempic 4 mg pens (4 doses of 1 mg weekly, or 8 doses of 0.5 mg) for $370 / pen + $50 shipping. They will fill more than 1 pen at a time. Discuss with Dr. Lazarus or heather.
4) Switch to Wegovy (~$900 / month) or Mounjaro (~$1150 / month)
5) Switch to Saxenda
6) We are happy to provide you with a paper copy of your prescription and you are welcome to fill it wherever you’d like; however, we will not submit prior-authorization paperwork for people without diabetes or pre-diabetes (pre-diabetes is occasionally, but usually not covered).
Alternatives to Ozempic / Wegovy
The oral weight loss medications like phentermine, Tenuate, Contrave and Qsymia remain good options for most people. In addition, the daily injectable, Saxenda, remains easily available, both through US and Canadian pharmacies. Daily Saxenda has similar weight loss efficacy as Saxenda, albeit less than full strength Wegovy; however, it can be a perfectly reasonable alternative in the interim.
Mounjaro may also be an option, particularly for patients with type 2 diabetes.
If you’d like to discuss changing treatment options, please schedule a visit with your Provider.
