Surges in semaglutide From the cover
The big picture
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 increased 300% since Ozempic was rst approved by the U.S. Food and Drug Administration in 2017, according to reports from health care analytics company Trilliant Health. The medications 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. “If placed on the list, patients taking compounded GLP-1 semaglutide would likely no longer be able to obtain it and would need to revert to Wegovy, brand name semaglutide for obesity,” Horn said. “Patented semaglutide is more expensive than compounded medication, and so many patients may nd themselves no longer able to a ord the medication.” Novo Nordisk spokesperson Eric Altho said the move is meant to protect the safety of patients who use semaglutide. “Semaglutide products t this description due to their inherent complexity and the potential dangers associated with attempting to compound them,” Altho 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.”
$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
Reported GLP-1 uses
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%
*NOTE: EXAMPLES OF “CHRONIC CONDITIONS” LISTED IN THE KFF SURVEYS ARE DIABETES OR HEART DISEASE.
C
Zooming out
What they're saying
The cost
The average cost of GLP-1 drugs ranges from $936-$1,023 for a one-month supply, according to the Kaiser Family Foundation. However, Horn said the production of com- pounded versions of semaglutides provides affordable access. “If the compounding pharmacies could demonstrate the efficacy and safety to the FDA, I would welcome the scenario as it would force the price of the patented drugs to come down,” Horn said.
Dr. Jason Balette, medical director over weight loss surgery at Memorial Hermann The Woodlands Medical Center, said he believes the rise in obesity in the population has created more desire for quick weight loss options. “What’s interesting to me is the transition from patients that will jump on a semaglutide or go down that pathway of trying to obtain a semaglutide and then reverting back to surgery,” Balette said. However, Dr. Tyler J. Varisco, assistant director at the University of Houston’s College of Pharmacy, expressed concerns that the widespread availability of compounded semaglutides has reduced the amount of available products for those struggling with diabetes and medical weight loss issues. “Health equity is important, and we want these drugs to be available to people who actually need them,” Varisco said. “I hate to see when we have national organizations … and 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 suffer.”
“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
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