Obesity patients say they have been scolded, and sniffed and sniggered at when trying to get the drug Ozempic since new guidance for doctors and pharmacists stressed it is indicated only for the treatment of diabetes.
The drug’s active ingredient, semaglutide, is approved to treat obesity but in a higher-dose form. However, Wegovy, a medication including the ingredient, is not available in Ireland. As a result, obesity doctors here have been prescribing lower-dose Ozempic to thousands of their patients.
The Medical Council last week issued guidance on Ozempic that “off-label” prescribing in an environment of short supply “poses a risk to patients for whom the medicine is indicated”.
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Since then, the obesity groups say patients who had been using Ozempic to treat their obesity have been told by pharmacists they can no longer receive it, and some have been scolded for using a drug that is in short supply.
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Rachel, from Meath, said she was grilled and sniggered at when asked to explain in her local pharmacy what she wanted Ozempic for. She said the pharmacist told her she was “taking life-saving medication out of the hands of a diabetic patient”.
“I felt scolded and humiliated and by this stage a queue had formed behind me. I was mortified,” she said, adding that she left the pharmacy “in tears” but managed to have the prescription filled elsewhere.
Elizabeth, from Dublin, said she has been refused the drug in her pharmacy for the past few months and told to get her GP to prescribe Saxenda, a more expensive and less effective drug that is indicated for obesity.
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Ozempic is a drug, designed for diabetics, but which has a game-changing secondary use. It has the power to transform the lives of people with complex obesity. It’s only available in Ireland for people with Type 2 diabetes – and in very limited circumstances for those with obesity. In this episode Bernice Harrison talks to Belinda from Tipperary, who after taking the drug for five months, has lost more than three stone. We also hear from Professor Donal O’Shea, HSE lead on obesity, who explains how the treatment works and how access to it has been put at risk by its association with celebrity weight loss, and its popularity on social media.
“I told them I am not in a position to pay out any more money monthly for medication as I already pay the drug payment scheme. They said there’s nothing they can do; they have to keep it for their diabetic customers,” she said.
Judge and jury
Mary, from Dublin, said she experienced “dismissive” and “sniffy” attitudes when she rang around pharmacies seeking to fill her Ozempic prescription as she wanted it to treat her obesity.
“I do think it’s an unfair position to put pharmacists in, where they are acting as judge and jury,” she said.
The Association for the Study of Obesity on the island of Ireland and the Irish Coalition for People Living with Obesity claim the Medical Council’s guidance “evokes an alarmist tone” and poses a risk to experts who are prescribing semaglutide to patients with obesity “in accordance with the evidence base and international guidelines”.
The guidance “further implies that people with obesity are less deserving of treatment than those living with diabetes and that their clinical need is less significant,” the two groups say.
“The guidance offered to pharmacists in the Medical Council communication poses a significant risk of increasing the bias and discrimination people living with obesity experience in the community.”
Untenable situation
Pharmacist Sheena Mitchell said her profession is now required to ask patients the clinical reason for their Ozempic prescription and whether it is diabetes or weight loss.
“This is an untenable situation that neither the pharmacist nor the patient is comfortable with. Patients are left feeling shamed and frustrated and pharmacists are upset that they cannot deliver the best patient care.”
The Medical Council told The Irish Times doctors are expected under ethical guidelines to use resources appropriately and responsibly.
“The statement did not infer (sic) that doctors should not prescribe Ozempic. Rather, its purpose was to raise awareness of supply issues and the need for mindful prescribing.”
