National Ozempic shortage impacting locals with diabetes, pharmacists

Persistent shortages of a popular diabetes drug — used off-label for weight loss — means some Calgarians with diabetes are making do without, while others seek out remaining stock.

The 1 mg pen dose of Ozempic, a prescription drug that is approved in Canada to treat adult patients with Type 2 diabetes mellitus, has been in short supply since August of this year.

According to the company that markets the drug in Canada, other smaller dosages of the drug are still available across Canada. 

Novo Nordisk said in an email to CBC news that supply challenges and increased demand for the product are to blame. 

Previously, some doctors and ethics experts have criticized the company for aggressively marketing both Ozempic and Rybelsus, another oral format of the drug semaglutide, in Canada due to concerns that people will seek out prescriptions for cosmetic weight loss.

Kerry Rasmussen says she hasn't been able to find any of the 1 mg once-a-week injection pens on the shelves in Calgary and she's had to make do with a daily oral substitute.

Rasmussen developed Type 2 diabetes in 2009 after first having gestational diabetes, she says Ozempic changed her life, she had more energy and her blood sugar levels were stable.

Now, she frustrated at having to use an alternative that requires daily habit changes.

"I don't have a lot of flexibility, like I do with the Ozempic," she said.

Ozempic has been approved for use in Canada since 2018, but its popularity, and the subsequent demand for the product, has grown. The diabetes drug can be prescribed off-label for weight loss.

"There have been reports, including in news and social media, that Ozempic is being used for weight loss. This is not an indication approved by Health Canada," reads Health Canada's website.

When asked for comment on Ozempic's off-label use, Health Canada replied in an email that "[The] decision to prescribe a drug for off-label use is part of the 'practice of medicine,' which involves the health care professional diagnosing a patient's symptoms and deciding which treatment would be most appropriate for that patient."

David Brewerton manages a pharmacy in northeast Calgary and says they receive about two calls an hour from people seeking Ozempic. 

"We are getting constant calls," he said.

Brewerton says they currently don't have any stock of the brand-name drug. They do have a compounder who makes semaglutide that they order from, but that takes time, and the drug doesn't have as long a shelf life.

To add to that, he says insurance companies are becoming more stringent in what they will cover.

"A lot of insurance companies say, 'No, we'll cover it under certain conditions. So [we'll cover it] for diabetes, but we won't cover it if it's for weight loss,' That's common," he said.

Ozempic lowers blood sugar and has the side effect of slowing digestion and making people feel full sooner, says Dr. David Lau, an endocrinologist and a professor in the Cumming School of Medicine at the University of Calgary.

"People who take Ozempic on a weekly basis tend to lose weight, in particular, lose body fat," he said.

"It has become quite popular, primarily because of the weight loss benefits of this medication in addition to its benefits in terms of lowering the blood sugar."

Dr. Lau says the injectable medication is also "much more powerful" than the comparable oral medication available in Canada in terms of its impact on blood sugar, adding to its appeal.

Health Canada says it is conserving existing supply of the drug, and monitoring supplies of other formats of the drug during the temporary shortage, and that patients should talk to their health-care provider about what options are available to them.

Novo Nordisk say that they are currently working to increase manufacturing capacity to meet demand, and in the short-term, patients should only fill their prescriptions up to 30 days and try reaching out to their pharmacist to ensure continued supply.

According to Health Canada, Novo Nordisk has advised them that the shortage of the Ozempic 1 mg pens is expected to resolve on Oct. 16.