Best Practices for Navigating GLP1 Agonist Drug Shortages

In recent months, demand for GLP1 (glucagon like peptide 1) receptor agonists has skyrocketed across the country, leaving providers inundated with prescription requests and patients frustrated with shortages. Semaglutide (Ozempic, Rybelsus, Wegovy), in particular, has been flying off the shelves as celebrities and social media personalities have shared weight loss success stories. 

GLP1 agonists have an important place in obesity therapy. However, there are many unanswered questions about long-term side effects, cost-effectiveness and the duration of therapy. Unfortunately, current manufacturing cannot adequately meet the demand for both diabetes and obesity treatment. The VHAN Pharmacy Team has the following recommendations for navigating ongoing shortages. 

1. Rely on lifestyle modifications and Food and Drug Administration (FDA) indicated alternatives for obesity.  The team recommends using medications that are FDA indicated for obesity in addition to behavioral modification and reduced food intake to treat obesity. Referral to a medical or surgical weight loss clinic can be considered for comprehensive weight loss therapy. Consult VHAN’s Obesity Care Path for more weight management guidance.  

2. Prioritize diabetes treatment. The increased demand for GLP1 agonists has been driven by off-label use in obesity. Depending on medication availability near you, it might be necessary to prioritize patients who rely on these medications for diabetes management. Many payors now require diabetes diagnosis for coverage. 

3. Empower patients. Drug shortages can put a lot of pressure on practice staff to find availability for patients. Instead, encourage patients to find out where they can fill a prescription for a GLP1 agonist. Understand that most pharmacies have the same supply challenges. 

4. Maintain some level of drug. Try to avoid patients missing doses and needing to re-titrate. For example, 2mg of Ozempic might help your patient more than 1 mg, but it’s better to maintain a lower dose than miss a dose completely. Adjust complementary therapies as needed to maintain disease control.  

5. Switch agents. At times, the availability of one product is better than others, and switching may be necessary. A dose equivalency chart is available here.

To learn more about GLP1 agonists, view this presentation on the VHAN Hub.