Its popularity for weight loss is hurting those who need it most. Telehealth and social media are playing a significant role in driving demand for Ozempic, a prescription drug that treats Type 2 diabetes, experts told CNN.
Following the DA communication, health professionals have now been asked to prescribe and dispense Ozempic for only those adults living with type 2 diabetes.
Ozempic is covered by most Medicare and insurance plans (source: MMIT). If you have a Medicare Part D or Medicare Advantage plan, about 85% will cover this medication.
Because it's an outpatient prescription drug, Ozempic falls under Medicare Part D. Original Medicare (Part A and/or Part B) won't cover it. Ozempic is No. 10 for the highest total Medicare Part D spending in 2021, according to data from the Centers for Medicare & Medicaid Services (CMS).
Medicare doesn't cover Ozempic (or Wegovy) for weight loss
Over 40% of U.S. adults age 60 and older are considered obese, according to 2017-2020 data from the Centers for Disease Control and Prevention. Despite the prevalence of obesity among older adults, Medicare won't cover weight loss drugs, including Wegovy.
You can be prescribed on the NHS via your GP if you're living with type 2 diabetes as an addition to diet and exercise. Additionally, semaglutide (the active ingredient in Ozempic) may be prescribed as part of Tier 3 weight management services.
A licensed healthcare professional (such as a doctor) will evaluate your health. If they determine that Ozempic may be right for you, they'll provide an electronic prescription. You can then order the medication through the service.
Ozempic is a highly sought after drug for managing diabetes and weight management, but it is important to know that it is prescription only. In Australia, this means you will need to speak with your doctor and have a prescription written up before you can start taking Ozempic.
Is Ozempic available for those without diabetes? Ozempic is only approved by the FDA for the treatment of type 2 diabetes. People who don't have diabetes may be able to take Ozempic “off-label” with a prescription from their doctor. “Off-label” means for use other than what is approved by the FDA.
It's not appropriate for people without Type 2 diabetes to receive a prescription for the drug, Jaisinghani notes.
If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1-, 2-, or 3-month prescription (maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription).
Ozempic isn't approved for weight loss. But because of how it works, some people taking Ozempic lose weight as a side effect. If you don't have diabetes, taking Ozempic for weight loss is considered an off-label use. Wegovy, a higher-dose version of Ozempic, is approved to help people manage their weight.
How Long Can You Stay on Ozempic (semaglutide)? A person can stay on Ozempic® so long as they are tolerating the medication and it is deemed appropriate by their treating provider. There is no specific time frame when someone should stop taking Ozempic as it is a medication that is intended for chronic (long-term) use.
So, on average, with the recommended starting Ozempic dose of 0.25 mg, a 500 to 1000 calorie reduced diet, and exercise 3 times a week, you can expect to lose 3-5 pounds in the first month of treatment, which works out to about 3% of body weight for most overweight or obese individuals.
Mounjaro is a more effective drug than Ozempic. As demonstrated above, tirzepatide (the active ingredient in Mounjaro) leads to more clinically significant weight loss and blood sugar reductions than semaglutide (the active ingredient in Ozempic).
You've hit a plateau
It's normal to eventually hit a point where your weight loss slows down, especially if you're not working on keeping or building up your muscle mass. Losing muscle along with fat slows your metabolism and can slow down your weight loss.
Ozempic to ramp up production driven by off-label demand
"There's nothing better than you not only losing weight, but also overall eating much healthier food." For those on the drug, Rubin recommends increasing your intake of lean protein such as chicken, turkey, fish, eggs, beans, soy and low-fat dairy.
Do not use Ozempic® if you or any of your family have ever had MTC, or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
How much weight can you lose on Ozempic or Wegovy? In randomized clinical trials, patients receiving the 2.4 milligram dose of semaglutide lost a mean of 6% of their weight by week 12 and 12% of their weight by week 28, researchers reported.
On the PBS, Ozempic costs Australians about $42 a month (four weekly injections). On a private prescription, the cost is about $132 a month.
If you qualify for insurance coverage, Ozempic can cost as little as $25 for a monthly supply. However, without insurance, Ozempic costs around $892.06 per month, on average (NovoCare-a, 2022). However, savings programs can sometimes help lower the cost of the medication if you qualify.
The TGA continues to advise people to source Ozempic only from Australian pharmacies with a valid prescription.
Saxenda is an approved weight loss medication, and is readily available in Australia. Cost is approximately $387 a month. The knock on effect from the Ozempic shortage, is that Trulicity which is manufactured by Ely-Lilly is now in short supply.