Glucagon-Like Peptide 1 (GLP-1) Agonist Use for Weight Loss: Drug Shortages and Labeled Indications
Date: 06/02/23
The GLP-1 agonist market was valued at US $16.53 billion and can increase up to US $24.10 billion by 2027 1 at a Compound Annual Growth Rate (CAGR) of 6.48%, during the forecast period of 2022-20271.
Semaglutide and liraglutide are GLP-1 agonist medications that are approved for treatment in type 2 diabetes, prevention of cardiovascular disorders in patients with type 2 diabetes, and weight loss. Semaglutide has several formulations: Ozempic (type 2 diabetes), Rybelsus (type 2 diabetes), and Wegovy (weight loss). Liraglutide is available as Victoza (type 2 diabetes) and Saxenda (weight loss).
For the primary treatment of weight loss, a medication such as Wegovy is an option for patients who have struggled to lose weight through diet and exercise alone, have a Body Mass Index (BMI) of 30 or higher, and are willing to use a once-weekly injection long term. However, social media attention has highlighted the use of Ozempic for weight loss as well2. Increased demand for Ozempic for weight loss and a national drug shortage of Wegovy has caused shortages with Ozempic for patients with type 2 diabetes3.
This trend has started to be seen with a newly approved medication, Mounjaro, as well4. Although, semaglutide and liraglutide have formulations that are FDA approved to treat obesity, Mounjaro is only FDA-approved for treatment of type 2 diabetes. Louisiana Healthcare connections records show that from July 2022 to January 2023, Mounjaro requests have increased 8,867% in 6 months with an average 314% month over month during this time frame. Although a majority are approved with the appropriate diagnosis of type 2 diabetes, obesity is also one of the top reasons for requesting the medication and being denied as an excluded benefit.
Below is a reference chart for GLP-1 agonist medications. Please evaluate your patients to ensure they are utilizing the medications appropriately and as indicated.
* Coverage is determined by formulary restrictions for Ambetter and Louisiana Department of Health for Medicaid.
| Medication | FDA Approved Indication | Dosing Frequency and Route | Medicad | Ambetter Coverage *PA required for all medications |
|---|---|---|---|---|
| Dulaglutide (Trulicity) | Type II DM | Once weekly SQ injection SQ injection | Preferred | Formulary Tier 2 |
| Exenatide, extended release (Bydureon / Bydureon BCise) | Type II DM | Once weekly SQ injections | Non-preferred (Bydureon BCise only) | Non-formulary |
| Exenatide (Byetta) | Type II DM | Twice daily SQ injection | Preferred | Non-formulary |
| Liraglutide (Victoza) | Type II DM | Once daily SQ injection | Preferred | Formulary Tier 2 |
| Liraglutide (Saxenda) | Obesity | Once daily SQ injection | Non-covered benefit | Non-covered benefit |
Lixisenatide (Adlyxin) | Type II DM | Once daily SQ injection | Non-preferred | Non-formulary |
| Semaglutide (Ozempic) | Type II DM | Once weekly SQ injection | Preferred | Formulary Tier 2 |
| Semaglutide (Wegovy) | Obesity | Once weekly SQ injection | Non-covered benefit | Non-covered benefit |
| Semaglutide, oral (Rybelsus) | Type II DM | Once daily tablet | Non-preferred | Non-formulary |
| Tirzepatide (Mounjaro) | Type II DM | Once weekly SQ injection | Non-preferred | Non-formulary |
References:
1. Daedal Research. (2023). Global Glucagon-like Peptide 1 (GLP-1) Market: Analysis By Product (Trulicity, Ozempic, Victoza, Rybelsus and Other GLP 1 Products), By Route of Administration (Injectable and Oral Medication), By Region Size and Trends with Impact of COVID-19 and Forecast up to 2027. Research and Market. https://www.researchandmarkets.com/reports/5715301/global-glucagon-like-peptide-1-glp-1-market?utm_source=CI&utm_medium=PressRelease&utm_code=cfrclv&utm_campaign=1814604+-+Global+Glucagon-like+Peptide+1+(GLP-1)+Market+Report+2023%3a+A+%2424.1+Billion+Market+by+2027+from+%2416.53+Billion+in+2021+with+Rising+Cases+of+Diabetes+and+Obesity+Contributing+to+Growth&utm_exec=chdo54prd-glucagon?w=5
2. Yang A. (2022). National Geographic. What to know about Ozempic, TikTok’s favorite weight loss drug. https://www.nationalgeographic.com/science/article/ozempic-tiktoks-favorite-weight-loss-drug-is-unproven
3. Wheeler M, PharmD. (2023). ASHP. https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=813
4. Farache E. (2023). Independent. The ‘next Ozempic’ became a social media sensation. Then everything changed. https://www.independent.co.uk/news/world/americas/mounjaro-shortage-update-weight-loss-ozempic-b2290860.html