Team Metabolic Health
It has been labelled a “miracle drug” and has become a trending hashtag on social media, with celebrities like Sharon Osbourne, Rebel Wilson and US comedian Tracy Morgan touting its weight-loss benefits.
Yet more than six years after Ozempic first came onto the global market, Kiwis are still not able to get their hands on a drug many claim is the answer to shedding stubborn kilos for those who have tried nearly every other weight-loss strategy.
Peter Shepherd, a molecular medicine professor at Auckland University and expert in diabetes and obesity, says the long-term impact of Ozempic “could be huge” for New Zealanders.
“We can argue till the cows come home about whether people should lose weight themselves the so-called ‘hard way’, but the reality is, for many, it is just not happening. So either we sit here and ignore [the obesity problem], or we do something about it.”
Ozempic mimics a hormone called GLP-1, which helps lower blood sugar and promotes a feeling of fullness, making it easier for users to cut out snacking.
Shepherd is supportive of the drug being funded in New Zealand as he believes the greater health benefits of a decline in obesity – like a decrease in cardiovascular disease, less kidney dialysis and even improved mental health – would be a worthy return on investment.
The injectable drug Ozempic has been approved for the treatment of type-2 diabetes in New Zealand, but it is not sold here currently. (File photo) ASSOCIATED PRESS
‘Life-changing’ for one Kiwi
Since Ozempic is not sold in New Zealand, only a handful of Kiwis have been able to use the drug.
One of them is Wellington company director Finlay Thompson. For him, it was “life-changing”.
He enrolled in an international clinical trial in April last year, which aimed to research the effects of taking Ozempic along with another non-weight loss drug.
Weighing 138kg, Thompson says he struggled with his weight for years and unsuccessfully tried every kind of diet and exercise programme under the sun to shift it. When he got the chance to take Ozempic, he jumped at it.
And the weight started falling off.
“It is hard to explain, but it changed the way I felt about food. Before the trial, I was basically thinking about food the whole time, but when I was on Ozempic, I no longer felt like that. It all went away.
“Suddenly when I went to functions or dinners, I ate and became quite full, where before I could eat and eat and never really feel full. It was quite odd.”
Thompson lost 30kg before his weight plateaued at 108kg. He says the trial required him to stop taking Ozempic about a month ago, with researchers now studying the effects after patients stop taking the drug. So far he hasn’t regained any of the weight he lost.
He experienced some side effects while taking the drug, “mostly gut-related”, but says these were nothing compared to the health impacts of being overweight.
Thompson says while he would still like to lose another 8kg or 9kg, the 30kg loss is “enough” to have changed his life.
“At 138kg, that’s quite a debilitating state to be in. Everything is just easier now, even just walking around. Imagine walking around with a heavy 30kg bag and then just putting it down. It makes a massive difference.”
The drug comes with the risk of side effects like nausea, diarrhoea and constipation, but serious side effects are rare, Shepherd says.
“It’s not the final solution. There will be learnings as we go on that will lead us to, say, identify the people for whom this is the right drug or limit the side effects. It is very exciting, but we will learn along the way.”
Diabetes drug used for weight loss
Ozempic, the trade name for a semaglutide injection, was developed to treat type 2-diabetes. Semaglutide works by mimicking a hormone called GLP-1, which helps lower blood sugar and promotes a feeling of fullness.
Ozempic is changing eating habits, and food companies are taking notice
“GLP-1 was found to improve the way we produce insulin, and so the idea was to develop this as an anti-diabetic drug to improve the body’s ability to release the right amount of insulin,” Shepherd says.
“Then it was realised that when you had higher doses of this GLP-1, people started to lose a bit of weight. And so what they did was develop chemical ways to make the drug last longer in your blood.
“So what Ozempic is is basically a modified human hormone that helps treat diabetes and also has weight-loss effects.”
Ozempic is made by Danish pharmaceutical company Novo Nordisk, the same company behind popular weight-loss drug Wegovy, which is also a semaglutide injection.
Its direct competitor is American pharmaceutical company Eli Lilly, which sells a similar drug under the brand names Mounjaro, for diabetes, and Zepbound, for weight loss.
Shepherd explains Ozempic is not the same as Saxenda, an anti-diabetic prescription medication currently available and used for weight loss in New Zealand. Saxenda is not funded.
Saxenda is a form of liraglutide rather than semaglutide, and Shepherd says although it is similar, “semaglutide hangs around longer and so it is more effective”.
Ozempic does not work for everyone and some find the side effects unbearable.
Medsafe announced in June last year it has approved Ozempic for the treatment of type 2 diabetes. Despite the regulatory approval, Novo Nordisk has still not launched the product here.
Professor Peter Shepherd, a molecular medicine professor at Auckland University and expert in diabetes and obesity, is supportive of Ozempic being funded as the greater health benefits of a decline in obesity would be a worthy return on investment.
A spokesperson for the company says it is “exploring options to provide access to Ozempic for people living with type-2 diabetes in New Zealand”, but did not respond to a question about when the drug will be available.
Information on the company website states that “increased demand for Ozempic”, coupled with “capacity constraints at some of the manufacturing sites”, have led to shortages of the drug, which are expected to continue throughout 2024.
“It is uncertain when supplies will be sufficient to fully meet current demand.”
The price tag
While there is no way to know what the sale price will be when Ozempic is finally launched in New Zealand, it could be similar to that in Australia, where a month-long supply costs about A$140 (about $150) if not funded via Australia’s Pharmaceutical Benefits Schedule.
This is significantly cheaper than in the US, where Ozempic retails for an average of US$936 a month – about $1480.
Saxenda currently sells in New Zealand for about $480 for a month’s supply.
Associate Professor Hesham Al-Sallami, a University of Otago expert on diabetes and obesity medication, believes if Ozempic or similar medicines were funded in New Zealand, it would take considerable pressure off the hospital system.
“If Ozempic can help patients lose weight, this could reduce the number of people getting type-2 diabetes in the first place,” Al-Sallami said in an article published on the university website last year.
“If this drug is made accessible in New Zealand as a weight-loss medication and is funded by Pharmac for that use as well, this could have considerably positive health outcomes for the country, taking pressure off the hospital system by reducing things like heart attacks and strokes.”
A Ministry of Health spokesperson says while Ozempic has not been approved as a treatment specifically for weight-loss in New Zealand (Novo Nordisk has not applied for this approval), Ozempic may still be prescribed by a medical practitioner for treating obesity.
“In these cases, the prescriber has the responsibility to ensure all treatment meets ethical and professional standards.
“If the use of a medicine is unapproved, the consumer should be advised, and the prescriber should discuss the evidence to support the use and any potential associated safety concerns.”
It is unclear whether any New Zealanders are importing Ozempic from overseas for personal use.
While it is legally possible to do so, the process is cumbersome and might prove difficult given there is a global shortage of Ozempic.
In August, the Australian Therapeutic Goods Administration reviewed the shortage of the drug and advised clinicians not to start new patients on Ozempic unless absolutely needed, and consider changing patients already on Ozempic to an alternative “as continuous supply cannot be guaranteed”.
The UK Department of Health and Social Care has banned the export of all forms of semaglutide and, according to media reports, many other European countries are considering imposing the same ban.
Another complication in importing Ozempic is the fact that it should be kept refrigerated at 2C to 8C.
A Medsafe spokesperson says Kiwis are allowed to import Ozempic from overseas if they have the authority from a New Zealand-registered authorised prescriber (usually their GP).
“Medsafe continues to warn that ordering medicines over the internet can be a risky business as a site may be located overseas and not have the credentials it claims to have,” the spokesperson says.
“In particular, ordering medicines is fraught with problems exposing the purchaser to poor quality and possibly counterfeit products from potentially illegal sources.”
Credit: thepress.co.nz