The shortage of anti-diabetes drugs used to lose weight continues, with subcutaneous formulations now unavailable in pharmacies. Taking stock with Adnkronos Salute is Angelo Avogaro, president of the Italian Diabetology Society Sid and of Fesdi (Federation of Diabetology Societies).
“Do we feel the impact of the shortage” of the injectable anti-diabetes medicines semaglutide (Ozempic*) and liraglutide (Victoza*), which have been at the center of a boom in applications for months? “Yes, patients certainly feel it, they notice it regarding the subcutaneous formulation. Before November it seemed that the situation had partially normalized, but then in an instant it worsened. And now I believe it is also linked to limitations of production type of the company. But we are talking about a molecule that can be given with subcutaneous or oral injections. And what is currently missing is the availability for the subcutaneous one: patients complain about the impossibility of finding it in the pharmacy. So there is It's clearly some management problem.” Taking stock with Adnkronos Salute is Angelo Avogaro, president of the Italian Diabetology Society Sid and of Fesdi (Federation of Diabetology Societies).
It was mid-November 2023 when the Italian drug agency Aifa published the note through which, with the company Novo Nordisk and the European drug agency EMA, it informed that the shortage of these two injectable agonist drugs of the Glp-1 receptor ( Glp-1 Ra) would continue intermittently throughout 2024. Increase in overall demand for drugs (which, due to their slimming effect, also meet the needs of patients with obesity) on the one hand and, on the other, limitations in production capacity in some of the production sites: these are the reasons. If we then add the celebrity conferred by the social effect, with showers of videos from influencers on TikTok and involuntary 'testimonials' such as the entrepreneur patron of Tesla and Space weight loss (Wegovy*), the picture is complete.
Same script in other European countries: for example in GB in recent days, while the Government warned of the shortage also citing the boom in demand for Ozempic for weight loss, the Department of Health and Social Care gave instructions to healthcare workers on how to manage this phase remembering not to prescribe the deficient drugs outside of their approved use and paving the way for new prescriptions of the tablet version. In fact, the British notice issued on 4 January specified the presence of sufficient stocks of this formulation, as explained by the 'Diabetes UK' association. “It works like this: either you transfer the patient to another drug in the family or you give the same compound by mouth, daily, trying to adjust the dose in proportion to the dose you took before. The important thing is that the patient takes that drug”, explains Avogaro. The increase in demand and prescriptions also occurred in Italy, obviously. And further growth “was determined by the famous AIFA note 100″ whereby these drugs can also be prescribed by general practitioners”, continues the expert.
“The opening of prescriptions to other professionals in addition to diabetologists has made the shortage” of medicines, which already existed, even more evident. These, adds Avogaro, “are very effective drugs. So they are very important. And they are doing well. There is scientific evidence that in a certain sense they protect the cardiovascular system and therefore colleagues are prescribing them more and more. ' more expensive than other drugs, but it's about the lives of patients. And we see the promised turning point materialising, in the sense that “we are able to manage them better”.
As for the shortages, “we had been alerted directly by the company, also to limit the entry of new patients into therapy as much as possible in order to give old ones the opportunity to continue taking the drug. Clearly it is difficult”. Also regarding those who use Glp-1 RA for weight loss, Avogaro specifies: “These are drugs that work very well in obese patients. The State does not reimburse them, but the specialist can prescribe them. There is therefore a whole segment of patients who pay for weight loss therapy out of their own pocket, a correct therapy that helps you lose weight, it should be noted. And if we calculate that 4-5 patients out of 10 are overweight in Italy, obviously it is easy to calculate how much it has an impact. It has a lot of impact.”
For its part, the company is investing in the expansion of its production plants, as communicated in two notes last November. Plants in both Denmark and France. Objective: to increase the capacity to satisfy future market demands, Novo Nordisk explained in communications on the site, specifying that the investment also includes GLP-1 products. Meanwhile, specialists are looking ahead to what lies ahead for 2024 which has just begun. “We certainly expect some more clarification regarding diabetes management as a whole – observes Avogaro – and how chronicity will be managed also based on what will be implemented with the Pnrr”, National Recovery and Resilience Plan. “That is, I am thinking of community houses, the role of the diabetologist, how many diabetologists, how to structure diabetes care – he lists – But above all what we expect is that a patient who is diabetic in Calabria has the same treatment as the patient in Veneto It is important to standardize diabetes care throughout Italy.”
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