Producing the drug – delivered as a weekly self-administered injection – includes a singular manufacturing set-up, so it would take a while to re-establish a world provide.
It’s anticipated again in Australia on the finish of March.
Semaglutide (within the type of Ozempic) is an efficient medicine in managing kind 2 diabetes – and the scarcity has left some folks with diabetes struggling to search out pharmacies with their remedy in inventory.
For many individuals with diabetes, Ozempic has managed their blood sugar (and sometimes additionally helped them shed some pounds) extra successfully than different medicines.
Due to the scarcity of Ozempic, Australian GPs have been suggested towards prescribing it to deal with weight problems.
However, semaglutide within the type of Wegovy is designed particularly for weight reduction. United States and Australian regulators have just lately accredited Wegovy for that goal, although it hasn’t been accessible to be used in Australia up to now.
When the scarcity is resolved and semaglutide is as soon as once more accessible in Australia for these with diabetes, it is unclear who will be capable of entry it for weight reduction.
Patients and docs are additionally asking how a lot they may pay, and what position it would play in managing weight problems.
Semaglutide works in a number of methods, together with growing emotions of fullness by performing on urge for food centres within the mind and slowing abdomen emptying.
It impacts the secretion of insulin and glucagon, which is why it’s so efficient in diabetes.
It additionally reduces the chance of coronary heart assaults and strokes. Other weight-loss medicine up to now have diminished weight however elevated the chance of dying from a coronary heart assault, which made them general too harmful.
Studies present semaglutide helps 66-84 per cent of people that use the drug to shed some pounds, making it more practical than different medicine in the marketplace
After two years, sufferers utilizing it nonetheless profit by not regaining their misplaced weight – however provided that they’re nonetheless taking the drug.
Disappointingly, as soon as stopped, sufferers discover a gradual regain of as much as two-thirds of the load they misplaced. So primarily, semaglutide works solely whereas taking it – it “manages” however doesn’t “cure”.
Semaglutide is supposed to be an add-on, not a alternative, for train and a nutritious diet.
Research on the medicine has all the time been executed along side a nutritious diet and train, as that’s thought-about greatest follow.
So we do not know what occurs for those who simply take the medicine with out additionally beginning or sustaining a wholesome way of life. We do know train is essential to holding weight off over time.
What are the unwanted side effects?
Semaglutide could cause nausea, bloating, constipation and diarrhoea.
Questions have been raised across the threat of pancreatitis, and thyroid and pancreatic cancers.
So far the analysis is reassuring, nevertheless these are all uncommon, so it is unlikely we are going to know if there’s any vital enhance for some years to return.
One of the largest boundaries to semaglutide for weight reduction is the fee. Although sufferers spend much less on meals whereas taking it, in 2022 (when it was extra simply accessible in Australia) it value round $130 a month.
It could possibly be pricier as soon as provide points are mounted, as a result of the producer Novo Nordisk is spending thousands and thousands of {dollars} constructing new services to satisfy the elevated demand.
In the United States, costs are already over US$1000 a month except lined by insurance coverage.
Australians with diabetes will proceed to have the ability to entry the drug on the Pharmaceutical Benefits Scheme (PBS) for the standard value of a script. However, if used for weight problems, it might be on a non-public prescription, so the fee continues to be unknown.
Obesity is extra frequent amongst folks with decrease incomes.
So from a public well being perspective, those that would profit probably the most might least afford it. This lack of fairness should be wrestled with if this medicine turns into extensively used for weight problems administration. Subsidising on the PBS for weight reduction is one possibility.
A critical concern is the potential for semaglutide for use by people who find themselves not overweight, significantly these with consuming problems. Because it suppresses urge for food, it may allow folks to starve themselves in an unhealthy method.
Obesity is outlined as a physique mass index (BMI) of over 30, and obese is BMI of 25-30. Yet there are experiences of individuals with BMIs lower than 25 utilizing it to drop “just a bit of weight”.
The psychological and social stress to be skinny is a strong driver, significantly in a society that often stigmatises weight problems. People may even see semaglutide as a method of “treating” their physique picture points.
Another concern is the impression on having fun with meals. Patients really feel full after only a few bites, making meals with associates awkward, and typically limiting their social life.
Why have docs prescribed it for weight reduction?
First-line weight problems administration ought to all the time be way of life interventions: enhancing your food plan and getting extra train, with the assistance of a multidisciplinary group.
But when that is inadequate, sufferers’ choices are restricted. The handiest is bariatric surgical procedure. Although surgical procedure is mostly nicely tolerated, it’s an irreversible lifelong change.
Once the semaglutide entry points are resolved, Australian regulators ought to search enter from the neighborhood and from docs, and consider carefully in regards to the position the drug ought to play in Australia’s administration of weight problems and weight reduction.
In addition to equitable entry and safety for these with physique picture points, we are going to want clear, evidence-based tips that contemplate the psychological and social impression of the drug.
By Natasha Yates, Assistant Professor, General Practice, Bond University
