On my outpatient clinical rotations last year, I saw ample management of heart disease and smoking cessation counseling. I also saw the annual physicals and checkups. But what surprised me was how many patients were on medications that were just now becoming more mainstream. I’m sure you’ve heard of one in particular—Ozempic. But it wasn’t just Ozempic. There was also Wegovy and Mounjaro. These medications, in the family of semaglutides, were just starting to become more well-known not just for their management of diabetes but also for the dramatic weight loss they led to in some patients. Many of these patients had been diagnosed with their diabetes just a few months prior and had not been started on trials of other drugs that in years past would have been used prior to a drug like Ozempic. Now, these drugs are all the rage, and many patients go into their doctor’s office asking for them specifically by name.
Ozempic and drugs similar to it should be prioritized for patients who do not have other options. Because of the increased shortages, they should be limited to patients who have other options or are largely taking these drugs for weight loss purposes rather than a serious need for blood sugar control.
Since it was discovered how much these semaglutides can help with weight loss, they have been one of the most popular medications on the market. Those who have been on these drugs for several years prior are now running into a problem that they didn’t have before—they aren’t able to find the drug they need to keep their blood sugars in check. Shortages have been rampant over the last few years with no respite in sight. As one anonymous man in a recent Vogue article on the topic says, “Attempting to get it can be quite complicated; it’s like going on a scavenger hunt to find your own medicine.” It is clear that this is becoming a serious issue due in large part to the weight loss effects of these drugs that have made them more popular.
In the past year especially, I have heard countless stories from patients, family members, and acquaintances who had been on a semaglutide for years and had not been able to get a refill due to the increased prescriptions. These individuals have told me how they had never had this problem in past years. And this is not just a problem that is limited to a few weeks. This is an issue that can go on for months for some patients. One family member recounted to me the weight gain and difficulties managing their blood sugar when they were not able to get the dose of their Ozempic that they needed each week. This can lead to major public health issues as more and more patients are going without their medication and having their well-controlled diabetes turn into fluctuations in blood sugar that can have dire consequences.
Another issue has more recently developed due to these drug shortages. With the popularity of these drugs continuing to increase and the ease of being able to obtain them becoming increasingly lower, there are those who might take advantage of others. This is already something that has been reported in certain places. For example, counterfeit Ozempic has been reported to be found in both the U.S. and Europe. In one specific instance, it was found that insulin was being sold illegally under the name Ozempic, which can lead to hospitalizations as it causes seizures and dangerously low blood sugar. Surely, the increased demand for these drugs is what has allowed counterfeiters to create a market for themselves as well. In the grand scheme of things, this is a fairly new development, and it can really lead to dangerous situations for patients.
To be sure, these medications are extremely beneficial both for patients needing to keep their blood sugars down but also in terms of the weight loss effect they provide, as this can help to mitigate other effects of metabolic syndrome on the body. These medications have also been found to be exceedingly beneficial in patients with PCOS and have even been able to reduce symptoms of nonalcoholic steatohepatitis in a recent trial published in the New England Journal of Medicine. Clearly, there is more utility to them than simply managing a standard case of diabetes. The key is finding a balance and a way to prioritize certain patients over others when it comes to prescribing these scarce drugs.
If these diabetes drugs, which are so helpful in keeping blood sugar stable and helping to lose weight, were prescribed a bit more judiciously, patients who do not have other options would be able to receive their drugs more readily, and there would be no market for dangerous counterfeit drugs. There has to be a way to prioritize patients who need these drugs the most moving forward.
Yasmine Kamgarhaghighi is a medical student.
