Is Manitoba experiencing an Ozempic shortage?

Manitobans who are worried that the Ozempic shortage impacting the United States will reach the province have nothing to worry about, at least for right now, according to experts.

Ozempic is the brand name of a drug called semaglutide, which is used to treat Type 2 diabetes and is part of a class of medications called GLP-1 receptor agonists.

“Essentially it’s a diabetes medication that stimulates the pancreas to produce more insulin when the sugar is high,” explained Dr. Akshay Jain, an endocrinologist and clinical instructor at the University of British Columbia, in an interview on Thursday.

“As an additional effect, it also works on the satiety centre in the brain, so it promotes more satiety and reduces portion sizes.”

Over the last few months, reports have surfaced that Ozempic has been difficult to find in certain parts of the world, including the United States, Australia, Singapore and Southeast Asia. The reason for this shortage has to do with the fact that Ozempic shows results in terms of weight loss.

“The surging worldwide demand of this product due to how effective it is for both diabetes, cardiovascular protection and weight loss have made it very difficult for the manufacturer to keep up with this demand,” said Tim Smith, pharmacy practice advisor with Pharmacists Manitoba, in an interview on Friday.

“There have been intermittent shortages, most in other jurisdictions [other than Canada].”

Jain noted that because Ozempic’s effects are so strong when it comes to weight loss, it has been approved for the management of obesity by the U.S. Food and Drug Administration (FDA) and Health Canada under a different brand name called Wegovy.

He added that because of how common obesity is, Wegovy is in high demand. The demand for the medication has created shortages, which has prompted people to take Ozempic off-label, creating an Ozempic shortage as well.

“It’s the same molecule, but Wegovy is the brand that is approved for the management of obesity and Ozempic is the brand that’s approved for the management of diabetes,” Jain said.

“So people are shunting more of that Ozempic use for the management of obesity, and that has then created a shortage of Ozempic for managing diabetes.”

However, though there have been shortages in other countries, Manitoba and much of Canada have not experienced issues. As for why there are no shortages, there is no definitive answer.

Dr. Isanne Schacter, who works at the Health Sciences Centre and is an assistant professor with the Department of Internal Medicine at the University of Manitoba, suggested that it might have to do with the manufacturer of the Canadian Ozempic supply.

Smith noted the demand for Ozempic is just a lot higher in other parts of the world, particularly in the United States.

“I know the manufacturer is directing a lot of resources to the United States, but why that hasn’t trickled over into more impact here, I’m not sure,” Smith said.

As for whether Manitobans and other Canadians should be concerned about future shortages, it’s not something that can be ruled out entirely.

Smith noted there have been several drug shortages recently, including common drugs such as Amoxicillin and children’s Tylenol.

“Any time a drug that we see is being used by so many people, where there’s threats of a supply chain issues, that’s very concerning to us,” Smith said.

According to Jain, the demand for Ozempic has gone up “quite a bit” amid the off-label usage. He said if this continues and exceeds the supply, then there’s a chance of a potential shortage in the future.

For those who are worried that people with diabetes won’t be able to access the drug due to its usage for weight loss, Smith reminds them that obesity is a chronic disease that is a risk factor for many other health conditions.

He added that it’s important for people with diabetes to have access to Ozempic, but it’s also important to not stigmatize the treatment of obesity and act like it's less important.

“Certainly we want to make sure that people who have diabetes and who are prescribed this medication have access to it, but we shouldn’t be playing one side off of the other,” Smith said.

Smith added that drug shortages are nothing new and that pharmacists, on average, spend upwards of 20 to 25 per cent of their day navigating them.

“So [they are] helping to find alternative brands, alternative products that work similarly or really helping to reinvent the wheel in some cases to make sure that people continue to get the medications that help them to achieve their health goals.”