Glenn Patton says he’s not one to panic.
But the global shortage of a diabetes drug, Ozempichas, has diabetics like him worried, he says access to the drugs could mean the difference between life and death for him.
Its shortage is something experts attribute in part to the trend of off-label prescribing of the drug for weight loss.
Health Canada said it has not approved Ozempic for weight loss.
“As a retired firefighter … it takes a lot to shock me,” said Patton, a resident of South Lancaster, east of Cornwall, Ont.
“To walk into a pharmacy and ask for my prescription and be told, ‘Well, we don’t have it, we might not get it, you might want to start checking other pharmacies, and maybe by next March we’ll have it, it’s like, wow, wow, wow.”
Marketed as Ozempic, semaglutide injection is currently approved by Health Canada to treat type 2 diabetes. Semaglutide is a hormone that simultaneously stimulates the body to produce insulin and, in larger amounts, affects the part of the brain that suppresses appetite.
Health Canada previously said temporary disruptions in the supply of ozempicone-milligram injection pens could be expected from late August to early October, but lower-dose pens would still be available across the country.
However, in an emailed statement this month, a Health Canada spokesperson said “occasional shortages” of high-dose and lower-dose pens are ongoing. The department said the shortage is likely to last until March 31, 2024.
A spokesman for the drug’s maker, Novo Nordisk, attributed the shortage to “overall global supply constraints coupled with increased demand.”
Patton, who only has a three-week supply of the medication left, said he could not afford to wait until March.
“Now I’m injecting and I’m thinking, no, I have two pens, I have two needles left. So what am I going to do after the third?” he said.
“Is on [my] think every day.”
In search of supplies
Patton was diagnosed with diabetes almost six years ago and was prescribed Ozempic about three years ago.
Last month, his local pharmacy told him they didn’t have any milligram pens, and gave him several lower-dose pens that would last him a few weeks instead, he said.
Patton then began calling pharmacies around town to ask if they could fill his prescription. After being told no by six different pharmacies, he reached out to extended family members across Canada to ask for their help in finding a pharmacy that had the drug.
“None of them could find him,” he said. “I was pretty upset and upset.”
Patton said his doctor then suggested an alternative medication that he stopped taking three years ago after experiencing near-fatal side effects like a sudden and steep drop in blood sugar.
That’s why Paton said that Ozempić “changes life”.
“There’s a big difference if you’re taking it to lose 20 pounds for a Christmas party, as opposed to something that’s keeping you alive,” Patton said.
He is worried about the serious health consequences of not having the medicine and having to go back to his old medicine.
Pharmacists in trouble
According to Barry Power of the Canadian Pharmacists Association (CPhA), Patton’s story is not unique.
Power said he is hearing from pharmacists across the country that they are turning away patients because of the Ozempic shortage.
Some pharmacies still receive small supplies sporadically, Power said, leaving pharmacists to decide whose prescriptions to fill.
“Insecurity around the supply of medicines has a negative impact on the delivery of health care,” said Power.
He added that an internal survey conducted by the CPhA showed that between 25 and 50 percent of prescriptions for Ozempicat pharmacies nationwide are for weight loss.
The trend of losing weight causes a deficiency
The problem is that many of those prescriptions are aimed at people who don’t have diabetes or chronic obesity problems, said Dr. Judi Shiau, medical director of the Leaf Weight Management Clinic in Ottawa.
“There has been almost an overuse, and certain parties … may be using it more for other purposes, such as a cosmetic reason,” Shiau said.
“It’s the phenomenon of TikTok.”
She added that many online pharmacies purporting to sell the drug may be doing so without proper checks, making it an attractive route for those looking to lose weight quickly, but making the situation worse for diabetics.
Still, Shiau said the drug is “very significant” for treating obesity. She explained that Health Canada approved semaglutide, sold as Vegovi, for weight loss about two years ago, but the drug never came to Canada. As a result, clinicians turned to Ozempic, which is a different format of the same drug.
“Unfortunately, we’re kind of dealing with diabetes and obesity management and it’s not fair to patients.” [and] it’s not fair to the clinicians,” she said.
Shiau said she is now reducing Ozempic prescriptions at her clinic, reserving them for patients living with diabetes or serious health problems stemming from obesity.
Pover hopes other clinicians will follow suit.
“Ideally, healthcare providers would realize the severity of the deficiency and adjust their prescribing accordingly,” he said.
The manufacturer apologizes for the shortcoming
Novo Nordisk said in an emailed statement that the drug is “not marketed as a weight loss drug,” “is not approved for chronic weight management” and “does not advertise Ozempic for weight loss.”
He encouraged patients who are unable to fill their prescriptions to contact their healthcare providers to discuss alternatives.
Novo Nordiskad added that it apologizes to patients and healthcare professionals who may be affected.
Health Canada said in an email that while it does not approve the drug to be used for weight loss, “[the] The decision to prescribe a drug for an off-label use is part of the “practice of medicine,” which is regulated by provincial and territorial colleges of physicians and surgeons.
In its emailed statement, the College of Physicians and Surgeons of Ontario said it sets broad expectations about prescribing, but does not set specific guidelines for any particular drug and is not involved in the procurement or distribution of drugs.
Patton said that the lack of accountability of these institutions makes him feel helpless.
“I don’t care who it is.” Someone [needs] to step up and say: ‘OK, that’s enough. These drugs should be saved and kept only for the people who need them, because you could actually completely affect their lives, the rest of their lives and their life expectancy,” Patton said.
Health Canada said it is looking for “ways to conserve existing supplies, expedite supply to pharmacies and access supplies or alternatives approved by parties, if possible.”
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