The market for glucagon-like peptide-1 receptor agonists (GLP-1RAs) used for weight loss is evolving in Australia due to increasing demand. This change is particularly evident with medications like Ozempic, which has faced ongoing shortages, leading to a need for alternative treatments.
Ozempic Shortage
Ozempic, a widely used GLP-1RA, has been in short supply for an extended period. Novo Nordisk has informed the Therapeutic Goods Administration (TGA) that this limited supply will persist throughout 2024. Consequently, healthcare professionals are advised not to initiate new patients on Ozempic unless they have no suitable alternatives. The priority remains for patients with type 2 diabetes who are already stabilized on the medication.
Alternatives to Ozempic
Patients using Ozempic for weight loss are encouraged to consider alternatives, such as Wegovy, which is specifically approved for weight loss. Wegovy became available in Australia in August 2024, in various strengths (0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg). Studies show that Wegovy can facilitate long-term weight loss, with participants averaging a 10.2% reduction in body weight over four years. However, the cost is a significant barrier, priced around $460 per month for the recommended maintenance dose of 2.4 mg, compared to $150–$170 for Ozempic.
Stigma and Misunderstanding in Weight Management
Rory Johnston, a community pharmacist and diabetes educator, highlights the stigma surrounding weight management. Patients seeking treatment often face judgment and misconceptions regarding their conditions. Various medical issues, including polycystic ovarian syndrome, hypothyroidism, and certain medications, can contribute to weight gain. Johnston advocates for better understanding and treatment options for individuals without a type 2 diabetes diagnosis.
Mounjaro’s Recent Approval
Mounjaro (tirzepatide), initially listed for type 2 diabetes in July 2023, received TGA approval for chronic weight management in September 2024. Previously prescribed off-label for weight loss, it is now available in a pre-filled pen format, which simplifies administration compared to the single-dose vials. Mounjaro operates through dual mechanisms, enhancing insulin release and reducing appetite, making it a viable option for patients who have plateaued with other GLP-1RAs.
Cost and Administration Challenges
Despite its approval for weight management, Mounjaro remains expensive, with initiation doses costing around $395 monthly. Patients have reported challenges with self-administration from vials, leading to potential dosing errors and contamination. The introduction of the pre-filled KwikPen aims to streamline the administration process, but if prices remain high, uptake may not significantly increase.
Liraglutide’s Future
The cost of older GLP-1RAs, such as liraglutide (Victoza and Saxenda), is around $400 per month. While these medications have not faced shortages, the daily dosing regimen and high price make them less appealing. However, with generic versions of liraglutide emerging, there is potential for lower costs in the future. A recent application for a generic product has been submitted to the TGA, and if approved, it may meet the growing demand for effective weight management solutions.
Conclusion
As the landscape of injectable weight loss medicines in Australia shifts, the persistent shortages of Ozempic and high costs associated with alternatives like Wegovy and Mounjaro present challenges for patients. Increased understanding and stigma reduction surrounding weight management issues are crucial for improving access to suitable treatments. With ongoing developments in medication availability and pricing, there is hope for a more accessible and supportive environment for individuals seeking to manage their weight effectively.
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