GPs have been advised to start no new prescriptions for two key injectable GLP-1 receptor agonists amidst a global shortage.
The Primary Care Diabetes Society (PCDS) said it had recently been made aware of shortages of Ozempic (semaglutide) and Trulicity (dulaglutide) in the UK due to manufacturers being unable to keep up with global demand.
In response, GPs should take a proactive approach and identify patients already prescribed Ozempic to make them aware of supply issues, the PCDS advised.
Some reports, including from Australian regulators have warned that shortages have come after an unexpected increase in demand as a result of extensive prescribing for obesity management.
Draft NICE guidance published earlier this year recommended Wegovy – another semaglutide injection – for patients with obesity who are being treated by a specialist weight management service.
Both Ozempic and Wegovy are made by Novo Nordisk but Wegovy, which is targeted for weight management outside of diabetes, is not yet available in the UK.
The PCDS said the Department of Health and Social Care (DHSC) had issued a supply notification at the end of September that supplies of 1mg Ozempic for injection are out of stock until 17 October and after that, supplies will only be available for existing patients until January.
Ozempic 0.5 mg solution for injection remains available but can only support a partial uplift in demand, a statement from the PCDS said.
In addition, ‘supplies of Trulicity 0.75mg, 1.5mg, 3mg and 4.5mg solution for injection devices are limited until January 2023’ and will also only be available for existing patients, it added.
Supply issues may continue beyond January so to ensure people with diabetes can be safely initiated on or switched to alternative agents, GPs should also take a proactive approach and find all patients prescribed Ozempic to notify them of shortages.
Patients requiring alternatives because they cannot fill their prescription should be directed to clinicians with knowledge of prescribing alternatives, the PCDS said.
And where there is no available supply of Ozempic 1 mg, to avoid exacerbating supply issues, do not prescribe 2×0.5 mg pens, the Society advised.
Instead, they advised switching patients to oral semaglutide, liraglutide or exenatide and published a detailed table to guide prescribing decisions.
‘Alternative oral and parenteral GLP-1 receptor agonists remain available. This situation is not due to any manufacturing quality issue or regulatory action,’ the PCDS said.
‘The situation is rapidly changing. Although it has been stated that supplies of Ozempic 1 mg will be available for existing patients from the week commencing 17 October, the PCDS accepts the possibility that supply issues may persist up to or even beyond January 2023.’
Dr Becky Haines, a GP and clinical lead for diabetes in Gateshead, said: ‘The PCDS document is extremely comprehensive and helpful and my local pharmacist and medicines management colleagues have been working really hard this week on a local plan to lessen the impact for patients and clinicians.
‘It’s going to be difficult both for some existing patients on GLP1 treatment and also not as straightforward for new initiations, which is stressful at a time when all our services are so stretched already.’
The number of patients prescribed drugs for diabetes by their GP increased by almost 5% last year, according to official figures.
READERS' COMMENTS [3]
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But, what dose of individualised mince pies, sausage roll, beer, burgers and chips this winter is permissible?
Fine but scrap our targets for HbA1C. No tools, no job can be done.
Can someone just clarify why it is a good idea to identify the patients and tell them to panic?
They might all start ‘panic-buying’ and ordering repeats early, and then the supply problems will be even worse.
Does anyone not remember the ‘salt shortage’ of the 1970s? when there was no salt shortage, and not even supply difficulties until someone started a rumour an everybody went out panic-buying and emptying shelves at supermarkets.
Same with loo rolls during Pandemic – our local supermarket had them reduced on BOGOF only the week before, which certainly emptied their shelf of them!