Update: Prescribers advised not to start new patients on Ozempic

The pharmaceutical company that supplies Ozempic, Novo Nordisk, has recently advised the TGA and the Ozempic Medicine Shortage Action Group that supply will be limited for the rest of 2023 and throughout 2024.

Novo Nordisk advised that demand had accelerated in recent months, particularly for the low-dose (0.25/0.5 mg) version. This additional demand is caused mainly by a rapid increase in prescribing for off-label use (prescriptions for conditions other than those approved by the TGA).

The Therapeutic Goods Administration (TGA) consulted clinical and patient groups represented on the Medicine Shortage Action Group (MSAG). The advice of the action group to prescribers is:

• do not initiate new patients on Ozempic unless there are no suitable alternatives or there is a compelling clinical reason to do so
• for patients who are already prescribed Ozempic, consider if they can be changed to an alternative (by consulting appropriate prescribing guidelines) as continuous supply cannot be guaranteed
• supplies should be conserved for patients who are stabilised on Ozempic who have no other treatment options
• it is not known when the medicine will be available in sufficient quantities to meet the ongoing high demand.

Novo Nordisk has advised that very limited new supplies of Ozempic 0.25/0.5 mg would be available before the end of 2023 and there would be intermittent supply of all strengths of Ozempic for the rest of 2023 and throughout 2024.  Novo Nordisk advised that Australian Ozempic supplies for 2023 had been higher than 2022. They were continuing to increase manufacturing capacity but it would take time to build supply levels to meet global and local demand.

Ozempic is in shortage worldwide and the issue is not limited to Australia.

Information for patients

Ozempic’s TGA-approved ‘indication’ (reason for use) is for the management of type 2 diabetes not adequately managed by other medications, in conjunction with diet and exercise. If you are prescribed Ozempic for another reason, your doctor may decide to switch you to a different medicine. This is because supplies will be intermittent and are being conserved for people without other choices and for whom Ozempic is critical for their health.

Through the Medicines Shortage Action Group, we have been working with Novo Nordisk, pharmaceutical wholesalers, health professional organisations and patient groups representing people with diabetes and obesity to manage the shortage of Ozempic since April 2022. Currently we are asking health professionals not to prescribe Ozempic to new patients unless there are no suitable alternatives or there is a compelling clinical reason to do so. This advice is to conserve supply for patients who are already stabilised on this medicine and who do not have suitable alternatives.

Information for prescribers

After consultation with the Ozempic Medicine Shortage Action Group, we advise prescribers not to initiate new patients on Ozempic unless there are no suitable alternatives or there is a compelling clinical reason to do so.

Ozempic’s TGA-approved indication is for the management of type 2 diabetes not adequately managed by other medications, in conjunction with diet and exercise.

When deciding whether to continue treatment consult the appropriate prescribing guidelines. Prioritise patients for whom Ozempic will have the most clinical impact, including patients already stabilised on the medicine and without other treatment options.

Carefully consider which patients might be switched to alternatives.

Information for pharmacists

Pharmacists should continue to prioritise limited supplies of Ozempic to patients stabilised on treatment.

Pharmacists should be aware that stock availability can change and sudden spikes in demand due to stockpiling or off-label use may affect continuity of care for patients stabilised on Ozempic.