Demand for a so-called celebrity weight-loss drug has left Canberrans who need the drug for serious conditions sick and without supply.
Doctors have been asked to stop prescribing semaglutide, known by the brand name Ozempic, so patients already on the medication can access it.
A huge uptick in demand has been driven by social media hype and a belief it is a one-stop shop for weight loss, experts say.
Canberra resident Anna said she has been told by her endocrinologist she will need semaglutide, which is administered via injection, to manage her blood glucose levels for the rest of her life.
She said being unable to get the drug last year for five months caused hypoglycemic episodes, caused by a drop in blood glucose levels, leaving her struggling to stay conscious at times.
"That's when my hypoglycemia took quite a significant turn, where they actually started becoming medical emergency situations," Anna said.
She said her symptoms included speech and cognitive issues, rapid heart rate, intense heat, muscle weakness and spasms.
Anna's pharmacist stockpiled pens, or injections, meaning Anna has so far been able to access the medication as a priority patient.
But she and her partner are "seriously worried" that she will not be able to access it again.
"[The chemist] think they will have enough for this month, but they're not too sure about next month, next year," Anna said.
Anna has insulin resistance and hyperinsulinemic hypoglycemia.
Towards the end of 2022, tabloid websites and social media was saturated with news of Ozempic, a so-called "miracle" drug for weight loss.
It was reported that celebrities including Elon Musk, Chelsea Handler and Amy Schumer took injections, and that it was used by everyone in Hollywood.
Ozempic is supplied by drug company Novo Nordisk, and is created using a complex manufacturing process that has not been able to meet global demand.
In February 2023, the scheme processed 382 items in the ACT, and nearly 37,000 nationwide.
Only five months later in July, more than six times more items were processed in the ACT - nearly 2800 - and nearly five times more across the country - 218,000.
Ozempic supply is so low that in late September the Therapeutic Goods Administration (TGA) asked doctors to stop prescribing it, warning them that stock will be unreliable until the end of 2024.
These stock issues are caused by people ordering and stockpiling the drug for off-label use, meaning for reasons not approved by the TGA.
This includes weight loss.
Two doses of the Ozempic drug is subsidised under the Pharmaceutical Benefits Scheme (PBS) to help people manage type 2 diabetes.
Almost 1.2 million Australians had type 2 diabetes in 2021, which can lead to heart disease, kidney disease and stroke.
Many do not have an affordable alternative to Ozempic, Dr Gary Deed, chair of the diabetes specific interest group for the Royal Australian College of General Practitioners, said.
Patients are now being given a lower dose of the drug for the same price, Dr Deed said.
"They're affected clinically, but also economically, and the government hasn't addressed that," he said.
"It's distressing for patients when they have to shop around ... It's almost as if they have to plead to get their scripts."
The TGA said it had received hundreds of messages from people affected by the supply shortage, which began in April 2022.
"We recognise the importance of Ozempic for patients living with diabetes and the other chronic health conditions it is being used to treat, and we are taking this shortage very seriously," it said.
More people are wanting the drug for weight-loss following media coverage, Dr Deed said.
"Every GP is aware of people identifying that they think they need the drug, and coming in and asking. I think that's a common thing these days due to the power of social media," he said.
"All of us have been inundated."
The drug can suppress appetite but medication is not necessarily suitable for wanting to lose weight, Dr Deed said.
"The concern is that people are looking for simple, one-shop fixes for often a complex condition [that requires] dietician assessment, physical activity changes, even psychological support," he said.
While GPs are being asked to transition some patients off the drug, people have bypassed traditional prescribers.
Ozempic has been available for Australians to purchase online, with websites only requiring a simple survey.
Dr Deed said that "any online health advice needs to be taken with care", and the medication came with side effects.
"If you've already got a very unhealthy diet, affecting reduction of appetite may in fact aggravate nutritional deficiencies," he said.
"One would be very careful if you're female and reproduction age to use the medication because it's not to be used close to pregnancy."
Anna is disappointed that another drug, tirzepatide, sold under the brand name Mounjaro, was rejected by the PBS in July.
Anna said she has been told by her endocrinologist that Mounjaro could be "an absolute game changer for someone like me".
She said she has been told that without a subsidy it would cost her up to $700 a month, which she cannot afford as a parent of a child with disabilities.
Mounjaro is very effective at helping people manage diabetes and their weight, Dr Deed said.
While higher doses of the drug was more effective than a low dose of semaglutide, subsidising tirzepatide was not cost-effective, a PBS expert committee said.
It wants the company who produces the drug, Eli Lilly, to reduce the price.
Pharmaceutical companies decide how much they charge for their drugs, a spokesperson from the Department of Health and Aged Care said.
Eli Lilly said it was disappointed by the rejection but it "remains committed to making this medicine accessible for adult patients living with" type 2 diabetes.
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