Diabetes medication shortage worsens

Diabetes patients have been dealt yet another blow, with medication shortages expected to continue, and potentially worsen in the new year.
 
GPs have been warned to prepare for an impending shortage of tirzepatide (sold as Mounjaro), with some doses already out of stock in warehouses and at wholesalers.
 
The shortage comes just weeks after an international study found tirzepatide is more effective for weight loss than semaglutide (sold as Ozempic) in overweight or obese adults.
 
In Australia, dulaglutide and semaglutide are the only two glucagon-like peptide-1 receptor agonists (GLP-1 RAs) listed on the Pharmaceutical Benefits Scheme (PBS) for treatment of type 2 diabetes, but neither are approved for weight loss.
 
Despite this, Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, said 2.5 mg and 5 mg doses of tirzepatide are increasingly hard to come by.
 
He told newsGP the ongoing shortages are adding an extra layer of complexity to prescribing medications to those who need it.
 
‘Obviously doctors are prescribing it well above expectations, so again, we’re having trouble with it simply not being available for people who are looking at Mounjaro as an alternative,’ Dr Deed said.
 
‘It’s difficult because if you start a patient on these medications, there’s no guarantee that the clinical benefits or ongoing supply is going to be secure over the next few months.
 
‘It’s becoming a real extra burden in the clinical care of patients [who are] are feeling very frustrated, very annoyed.’
 
It is the latest in a long list of supply issues and potentially dangerous shortages for those living with diabetes.
 
The Therapeutic Goods Administration (TGA) has predicted a shortage of the Tik Tok-famous semaglutide will continue well into next year.
 
Meanwhile, shortages of dulaglutide (sold as Trulicity) are now expected to extend to 31 December next year, as the TGA continues to work with manufacturers to sure up supply.
 
Dr Deed said GPs are being forced to have difficult conversations with patients about starting a treatment while being unable to guarantee its ongoing availability.
 
‘Don’t prescribe off-label for people without diabetes. If we prescribed only to patients that are really at great need of it, there might be enough supply,’ he said.
 
‘Off-label prescribing might seem clinically appropriate, but it stops people who are most likely to benefit from it to get access.
 
‘It’s like going to the petrol station and driving all the way there with a very low tank and it’s just not available. There becomes a sense of desperation, a sense of disappointment and that’s frustrating because they can’t be guaranteed that if you go to a different chemist that the drug will be there anyway.’
 
The TGA has also urged prescribers to prioritise the medications for those most in need.
 
‘Do not initiate new patients on Ozempic unless there are no suitable alternatives or there is a compelling clinical reason to do so,’ it warned.
 
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