Delays getting higher dose Wegovy to patients reported by US doctors

[July 15, 2023]  By Maggie Fick, Patrick Wingrove and Elissa Welle
 
 LONDON/NEW YORK (Reuters) - Some U.S. patients taking the two highest doses of Novo Nordisk's Wegovy weight-loss drug are facing difficulty filling their prescriptions, eight doctors around the country told Reuters this week, suggesting a new supply challenge for the popular medicine.
 
 Wegovy is a weekly injection that can help patients shed 15% of their weight alongside diet and exercise changes. Its high efficacy has sparked huge demand in the U.S., where some 115 million adults and children are obese.
 
 Walgreens, one of the biggest U.S. pharmacies, is experiencing supply shortages for the higher strengths, spokesperson Erin Loverher confirmed.
 
 Novo told Reuters on Friday that there were no supply interruptions to its highest 1.7 milligram and 2.4 mg doses, repeating comments made in May, when it announced restrictions on lower doses.
 
 The Danish drugmaker in May said to cope with high Wegovy demand, it would reduce the supply of the three lower, or "starter", doses for several months to safeguard supplies for current patients.

Wegovy is available in five strengths. Patients are expected to reach the highest 2.4 mg dose after 17 weeks on the drug, though some doctors and patients say they are following a slower dosing schedule to mitigate side effects.
 
 Doctors in six U.S. states told Reuters patients are reporting problems filling their prescriptions for the higher doses. Three of the doctors said supply delays at pharmacies had resulted in patients missing their Wegovy injections at the prescribed weekly interval.
 
 Dr. Alicia Shelly, an internal medicine and obesity specialist at Wellstar Health System in Georgia, said she has heard from more than 20 of her obesity patients since the end of May who have experienced delays in getting prescriptions for the 1.7 and 2.4 mg doses filled.
 
 "They are being told by the pharmacists that they do not know when the medication will be available," said Shelly, adding that she has begun switching some patients to less effective weight-loss medications such as Novo's Saxenda.
 
 Obesity specialist Dr. Robert Kushner at Northwestern University's Feinberg School of Medicine, said the delays have caused some of his patients in the Chicago area to take their shot as much as four days late.
 
 "Patients are often having to delay their injections because it's harder for pharmacies to get Wegovy in stock," he said. He did not know of a patient who was unable to eventually fill their prescription, he added.
 
 "It's almost a game of Whack-A-Mole, to see which pharmacy (has supply)," he said.
 
 Patients on the highest doses of Wegovy who miss their weekly injection are likely to experience worse-than-normal gastrointestinal side effects such as vomiting once they take their next injection, according to Kushner, a concern echoed by other doctors interviewed for this story.

A selection of injector pens for the Saxenda weight loss drug are shown in this photo illustration in Chicago, Illinois, U.S., March 31, 2023. REUTERS/Jim Vondruska/Illustration/File Photo

'IT'S A STRUGGLE'

Denise Wells, a 57-year-old woman employed in the auto industry in Michigan, began taking Wegovy in February and has so far lost 40 pounds (18 kg). She started on the 1.7 mg dose in June, and on Friday is due to inject herself with the last of her four-dose monthly prescription.

After Walgreens was unable to fill her prescription for that dose last month, she switched to Amazon Pharmacy, but Amazon has yet to ship next month's supply.

Wells is worried about regaining weight if her refill does not arrive in the next week.

"You can't introduce something that is so life-changing and then be like, 'Ok, we are out.' Make some more," Wells said.

Amazon in a statement acknowledged the nationwide shortage of some weight-loss medications. "We are working closely with our suppliers and insurers as they work to address these challenges," it said.

Six other doctors - in Chicago, New York, San Francisco, Detroit, Atlanta and Charlottesville, Virginia - told Reuters of similar delay complaints from patients on the two higher doses.

Dr. Holly Lofton at New York University Langone, a general practitioner who specializes in obesity, said the delays could be a result of doctors prescribing higher Wegovy doses due to current company-imposed restrictions on the three lower doses.

Northwestern Medicine endocrinologist Disha Narang said up to 10 of the more than 100 patients she sees monthly reported recent problems filling their prescription and had to delay injections by 4-to-7 days.

"It's a struggle. Patients are not reliably able to get their Wegovy," she said.

Wegovy won U.S. approval in 2021 but soon faced supply constraints after it was launched due to problems with its contract manufacturer. That supply problem eased by the end of last year, and Wegovy use began to surge again early this year.

It reached around 135,000 prescriptions per week in May from 45,000 in the last week of January, according to Barclays Research, fuelling fears of shortages. In the last three weeks of June, total prescriptions written fell to around 100,000 per week, about 25% fewer than before Novo began restricting the starter doses.

"Novo really missed the mark in determining the demand for this medication," Narang said.

(Reporting by Maggie Fick in London and Patrick Wingrove and Elissa Welle in New York; Editing by Caroline Humer and Bill Berkrot)

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