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Medicines like Ozempic and Wegovy are now so popular for weight loss that they become hard to get, which is a problem for patients who take the drugs for Type 2 diabetes. NPR pharmaceuticals correspondent Sydney Lupkin reports.
SYDNEY LUPKIN, BYLINE: Jim Cox had heard about people with diabetes who were unable to get their Ozempic because the drug was being used off-label for weight loss. He just didn't think it would affect him. Cox, who has Type 2 diabetes, had been taking a drug called Trulicity. That's a GLP-1 drug and in the same class as Ozempic.
JIM COX: And then I went up to my local pharmacy to get my Trulicity, and they said, sorry, we're out. I couldn't renew my prescription.
LUPKIN: He's not alone. Trulicity and similar drugs like Ozempic and Mounjaro have all been in short supply over the last 18 months. Ro.co, a telehealth company, built a free online tool to help patients report shortages of these drugs. That company's CEO, Zach Reitano, said they received 35,000 reports of GLP-1 shortages within two weeks of launching the tool last month.
ZACH REITANO: It's sad that we received that many.
LUPKIN: These medications have been so wildly successful that the drugmakers can't keep up with demand. So says Rena Conti, a health economist at Boston University.
RENA CONTI: They should have been prepared to meet demand as it shifted, due to their very aggressive advertising campaigns.
LUPKIN: It's been hard to miss when you turn on the TV.
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UNIDENTIFIED VOICE ACTOR #1: Adults lost up to 14 pounds.
UNIDENTIFIED VOICE ACTOR #2: It could help you lose up to 10 pounds.
UNIDENTIFIED VOICE ACTOR #3: Plus, people taking Mounjaro lost up to 25 pounds.
LUPKIN: To be clear, all those ads touting the number of pounds patients lost were for drugs approved for diabetes, but that hasn't stopped people from using these drugs for weight loss anyway. For Cox, the diabetes patient who couldn't fill his prescription, this kind of advertising by drugmakers makes him angry.
COX: They just went overboard. They saw dollar signs, and they went for it. And they didn't consider the fact they are hurting their base clientele, their patients.
LUPKIN: For its part, Eli Lilly, which makes Trulicity and Mounjaro, has made public statements against using GLP-1 drugs for, quote, "cosmetic weight loss." And Novo Nordisk says it's direct-to-consumer advertising is meant to educate patients, not promote off-label use. Still, it turns out that conserving these medications for the people they were approved to treat is challenging.
CVS Caremark's solution involves looking at a patient's history to see whether there's any prior evidence of them having diabetes. If not, which happens about a third of the time, CVS Caremark will require a prior authorization, meaning the doctor will have to explain the prescription before it's covered. Here's Dr. Daniel Knecht, chief innovation officer at CVS Caremark.
DANIEL KNECHT: For those prescribers that go ahead and fill out that prior authorization, we're actually - we're rejecting about 84%, meaning that most of those patients are not actually diabetic and there's off-label use.
LUPKIN: Some doctors say that CVS Caremark's approach might cause more problems, however. Dr. Scott Isaacs is the president-elect of the American Association of Clinical Endocrinology. He says he might prescribe a diabetes drug to a weight loss patient and vice versa. The reason is he's trying to prescribe whichever drug is available and covered by the patient's insurance, and he's upset about a troubling trend at the pharmacy counter.
SCOTT ISAACS: I feel like it's obesity discrimination. You know, they would tell patients things like, you know, you don't deserve to be on this, or, you know, this is for patients with diabetes. You're abusing this drug, even, you know, if the doctor's prescribing it.
LUPKIN: He says both groups of patients do really need their medicines. It's unclear how soon the shortages will be resolved, but the drugmakers have invested in new factories and say they're ramping up production.
Sydney Lupkin, NPR News.
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