Surges in semaglutide From the cover
Zooming in
A closer look at GLP-1 drugs
adults have used GLP-1 drugs to lose weight or treat a chronic condition—such as diabetes or heart disease.
1 8 in
The demand for GLP-1 drugs is up locally said Dr. Todd Worley, who specializes in bariatric surgery and obesity medicine at Houston Methodist Willowbrook Hospital in north Houston. “Our [hospital’s] demand mirrors that of society, where so many people are wanting [GLP-1 drugs] or wanting to think about trying it,” Worley said. Demand for bariatric surgery peaked in 2022 at Houston Methodist Willowbrook Hospital, but demand for GLP-1 drugs began to rise the same year and peaked in 2023, Miller said. A request for data on GLP-1 demand was still pending with the hospital as of press time on Jan. 13. However, Dr. Tyler J. Varisco, assistant director at the University of Houston’s College of Pharmacy, expressed concerns that safety issues with compounded semaglutide—which he said often results from inaccurate dosing—could reduce access to GLP-1 drugs for patients in need. “Health equity is important and we want these drugs to be available to people who actually need them,” Varisco said. “I hate to see … some of these bigger telehealth providers that ... just write these medications for anybody, and then patients who are treated by local providers, who have had a quality visit, who have been assessed—they su er.”
$10.7B was spent nationally on semaglutides in 2021. A 300% increase in GLP-1 prescriptions was seen from the beginning of 2020 to the end of 2022. 22% of adults who have taken GLP-1 drugs received them from an online provider, website, medical spa or aesthetic medical center. 392 reports of adverse events with compounded semaglutide have been reported to the FDA in 2024.
GLP-1 drugs perform a number of functions including:
Targeting receptors in the brain to lessen cravings/hunger A
Side effects of GLP-1 drugs can include: • Nausea/vomiting • Diarrhea • Abdominal pain • Constipation
Slowing food down as it travels through the gut, keeping patients feeling fuller longer
B
Increasing the release of insulin
C
A
U.S. patient GLP-1 use
To treat a chronic condition* 39%
To lose weight 38%
B
SOURCES: KAISER FAMILY FOUNDATION SURVEY, U.S. FOOD AND DRUG ADMINISTRATION, UH COLLEGE OF PHARMACY, THE MAYO CLINIC, TRILLIANT HEALTH/ COMMUNITY IMPACT
Both 23%
*EXAMPLES OF CHRONIC CONDITIONS LISTED IN THE KFF SURVEYS ARE DIABETES OR HEART DISEASE.
C
The cost
What they're saying
The big picture
The average cost of a one-month supply of GLP-1 drugs ranges from $936-$1,023, per the Kaiser Family Foundation. Horn said the production of compounded versions of semaglutides provides affordable access. “If the compounding pharmacies could demonstrate the efficacy and safety to the [U.S. Food and Drug Administration], I would welcome the scenario as it would force the price of the patented drugs to come down,” Horn said.
The demand for GLP-1 drugs jumped 300% since Ozempic was first approved by the FDA in 2017, according to reports from health care analytics company Trilliant Health. Ozempic and Wegovy were added to the list of drug shortages by the FDA in March 2022, and are still listed as “currently in shortage” as of publication. Novo Nordisk spokesperson Eric Althoff said the move to prevent other pharmacies from recreating their own versions of the drug is meant to protect the safety of patients who use semaglutide. “Semaglutide products fit this description due to their inherent complexity and the potential dangers associated with attempting to compound them,” Althoff said. “Our nomination provides numerous examples of these risks, including unknown impurities, peptide-related impurities, incorrect strengths and even instances where no semaglutide was present in the product at all.” As of Nov. 30, the FDA has received almost 400 reports of “adverse events” from patients who used compounded semaglutide.
“At the end of the day, we have the public health to worry about,
and I think access will remain ... important.” TYLER J. VARISCO, ASSISTANT DIRECTOR, UNIVERSITY OF HOUSTON’S COLLEGE OF PHARMACY
Cost of various GLP-1 brands*
Ozempic injection $936 Wegovy injection $1,349
Rybelsus tablet $936 Mounjaro injection $1,023
“These drugs are inherently complex to compound safely, and the risks they pose to patient safety far outweigh any bene ts.” ERIC ALTHOFF,
Insurance coverage for GLP-1 drugs
19%
Insurance covered full cost Insurance covered part of cost Full cost paid by user
57%
24%
SPOKESPERSON, NOVO NORDISK
*AS OF AUG. 15, 2023
SOURCE: KFF/COMMUNITY IMPACT
20
COMMUNITYIMPACT.COM
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