It is the most outstanding scientific breakthrough of 2023 by Science magazine and the hen that lays the golden eggs for several pharmaceutical companies, especially Novo Nordisk, the Danish laboratory that has become the most valuable company in Europe. We are talking about the latest generation drugs to fight obesity, which mimic the action of the GLP-1 hormone and which have been shown to be very effective in losing weight. The demand – driven in part by the spread of the profits that Hollywood stars and other famous people, such as Elon Musk, have made on social networks – is so great that there is currently a shortage. And that has consequences. Without going too far, for patients with type 2 diabetes. It was for this pathology that they were developed at first, although later it was seen that they were very efficient in treating obesity. In Spain, most of the presentations marketed (Ozempic, from Novo Nordisk, is the star) are only indicated for diabetes. However, there are doctors – especially in private healthcare – who prescribe them for weight loss. Result? They are conspicuous by their absence in many pharmacies, a problem that may continue during this 2024, according to Novo Nordisk sources in La Vanguardia.
“Ozempic [with semaglutide as an active ingredient] is not the only drug that suffers from shortages. All medicines in the same family have this problem”, explains Antonio Pérez, director of the endocrinology and nutrition service unit at Sant Pau hospital and president of the Spanish Diabetes Society. “And there is also a lack of stock of Victoza (liraglutide) and Trulicity (dulaglutide). All three, which are injectable, are indicated in Spain only for patients with diabetes”.
The only one of this family of drugs that is currently authorized for weight loss in Spain is Saxenda (also from Novo Nordisk), which, like the rest, has supply problems. There is also the fact that it is more expensive than Ozempic. The latter, with a private prescription, is close to 130 euros for a one-month treatment, while Saxenda reaches 280 euros. “For this reason, people who used Saxenda have switched to Ozempic”, points out Antoni Torres, president of the Federation of Pharmacy Associations of Catalonia (Fefac). There is already on the market the equivalent of Ozempic indicated for weight loss (it is Wegovy, also from Novo Nordisk, with the same active principle, but a different dose), but it is not yet marketed in Spain.
Although they belong to the family of GLP-1 agonist drugs, Ozempic and Saxenda have a different active principle (semaglutide for the first; liraglutide for the second). “Liraglutide is of the first generation, while semaglutide is much more recent and generates more benefits”, says Dr. Núria Vilarrasa, specialist in endocrinology and nutrition at the Bellvitge hospital. The numbers say so. With Saxenda you lose between 5% and 6% of your initial weight after about two months, as long as the intake is accompanied by physical activity and a healthy diet. With semaglutide, the loss is even greater. “There are studies, with the Wegovy, done with obese people without diabetes in which the reduction is approximately 16%, also with a healthy diet and physical activity,” underlines Vilarrasa.
In addition to stimulating the pancreas to secrete insulin, these drugs slow gastric emptying, so they increase the feeling of fullness. And not only that. They act on the central nervous system and help reduce the feeling of hunger. They also reduce the risk of a cardiovascular accident by up to 20%.
That is why doctors, especially in private healthcare, are prescribing Ozempic for obesity (despite the fact that it is only indicated for type 2 diabetes), waiting for the arrival of Wegovy in Spain – in the United States, Denmark , Norway, Germany, Switzerland and the United Kingdom can now be acquired. This scenario has led to a lack of stock in pharmacies, which complicates life for diabetics, who practically do not have a plan B. “One solution is to look for it in another pharmacy or talk to the pharmacist to get it for you guarding”, argues Antonio Pérez. Sources from the Diabetes Association of Catalonia (ADC) assure that many of the members hit the waiting lists of the pharmacies, a problem – they say – that causes them anxiety.
Another option would be to switch to a drug from the same family, “but there is also waste”, Pérez recalls. There is – he continues – the oral alternative to Ozempic (Rybelsus, also from Novo Nordisk), but it is a newer drug. “There are more studies on Ozempic. It is known not only to affect diabetes and weight, but also to reduce the risk of cardiovascular disease. With the Rybelsus there is still no such study”, concludes Pérez.
