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December 7, 2022

Why it's so hard to find weight-loss drugs right now

Daily Briefing

    Novo Nordisk's popular weight-loss drug Wegovy is difficult for patients to find right now—as are other, similar GLP-1 drugs such as Eli Lilly's Mounjaro—due to supply shortages, massive demand, and restrictions from drugmakers on who is allowed to use the medications.

    A spike in demand

    GLP-1 drugs mimic a hormone called glucagon-like peptide-1 to target areas of the brain that regulate appetite and food intake. In 2021, FDA approved Wegovy for the treatment of obesity after a clinical trial showed it helped patients lose an average of 15% of their body weight over 68 weeks. Mounjaro has also been approved by FDA but only to treat Type 2 diabetes.

    However, many patients are finding it difficult to access these drugs, in part because of supply shortages.

    "Demand for these new agents has been unlike anything I've ever seen in my time in medicine," said Michael Albert, a physician specializing in weight-loss treatment at Accomplish Health. According to Albert, many of his patients started asking about Wegovy after hearing about it on Facebook and TikTok.

    According to Novo Nordisk CEO Lars Fruergaard Jørgensen, it took just five weeks for the volume of Wegovy prescriptions to hit the same weekly levels it took Novo Nordisk's old obesity drug, Saxenda, four years to reach.

    "It's a completely different ballgame that we're in," said Ambre Brown Morely, Novo Nordisk's VP of media and digital communication.

    Novo Nordisk didn't anticipate the level of demand it ended up seeing and, as a result, has been forced to allocate Wegovy to only patients who have already started taking it.

    "We should have forecasted better, which we did not," Jørgensen said. "Had we forecasted that, we would have built a different supply chain."

    Jørgensen said the company has increased its capacity and plans a "relaunch" of Wegovy early next year, which should fulfill all orders for the drug.

    Restrictions on who can take weight-loss drugs

    GLP-1 drugs have also been hard to come by because of restrictions from drugmakers on who doctors can prescribe the drugs to. Eli Lilly, for example, allows only patients who confirm a type 2 diabetes diagnosis to receive Mounjaro.

    But many patients with clinical obesity have been turning to the drug as one of the few treatment options available to them.

    While it's understandable that Eli Lilly would target Mounjaro to the people it's intended for, the situation is "unfair to everybody," said W. Scott Butsch, director of obesity medicine in the Bariatric and Metabolic Institute at the Cleveland Clinic. "It's unfair to people who have obesity because there's a drug that actually can very well help them and there's a provider who wants to treat obesity, yet does not have access to a very reasonable treatment."

    Butsch added that, while patients with diabetes have some other medications available to them, patients with obesity have few other treatment options.

    In addition, there's a large overlap between diabetes and obesity, and patients with obesity have a high risk of eventually developing diabetes, according to Beverly Tchang, an endocrinologist and assistant professor of clinical medicine at Weill Cornell Medicine.

    "Obesity can lead to diabetes, diabetes can lead to obesity," she said. "They're very much intertwined, and to treat one but not the other seems inequitable."

    It seems that people "want to 'save the medication' for the people who 'need it,' and I understand that sentiment," Tchang added. But "we need to look at obesity as its own disease that is equally deserving of treatment." (Loftus/Roland, Wall Street Journal, 12/4; Chen, STAT, 12/7)

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