Off-Label Use of Ozempic Leads to Wordwide Shortage

An increasing number of countries are now outlawing the drug for weight loss and are also banning exports.

Boxes of Ozempic rest on a pharmacy counter in Los Angeles, California, on April 17, 2023. Mario Tama/Getty Images

The popularity of Ozempic’s off-label use for weight loss is driving a worldwide shortage of the diabetes drug that is likely to last through spring of 2024.

Around the world, pharmacies have reported shortages, including U.S., Canada and Europe. Some countries are taking drastic measures to protect patients with diabetes whose health depends on the drug by banning the use of Ozempic for weight loss.

Just two weeks ago,  on Nov. 14, Belgium joined Great Britain in outlawing the drug for weight loss use until summer 2024. France and Austria have already banned the export of the drug. Germany is considering implementing both options.

When a Blockbuster Drug Backfires

Manufactured by Novo Nordisk, Ozempic is one of three FDA-approved semaglutide drugs, along with Wegovy and Rybelsus. Semaglutides help regulate the secretion of hormones like insulin, while slowing stomach emptying and reducing hunger signals in the brain. Of the three, only Wegovy is FDA-approved for chronic weight management.

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The healthcare technology company DrFirst reported a 150 percent increase in semaglutide prescriptions among its network of 350,000 doctors between December 2022 and June 2023.

Wegovy, approved in 2021, has been on the FDA’s drug shortage list since March 2022. In August 2023, Novo Nordisk’s CEO Lars Fruergaard Jørgensen said that rising demand could perpetuate shortages for years.

As of Nov. 10, 2023, Novo Nordisk’s website acknowledged supply chain issues and surging demand for its weight loss and diabetes drugs. “We anticipate ongoing supply disruption, and are aware that some patients will continue having difficulty filling Wegovy prescriptions,” the message reads.

Now Ozempic joins the shortage list as more people rely on its off-label use for weight loss. Analytics from Trilliant Health, a marketing research company, show U.S. healthcare providers wrote over 9 million prescriptions for Ozempic, Wegovy and similar diabetes and obesity drugs in the last three months of 2022—a 300 percent increase since early 2020.

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Nearly one in three U.S. adults is overweight, over two in five are obese, and one in 11 has severe obesity, per the National Institute of Diabetes and Digestive and Kidney Diseases. About 37 million Americans have diabetes, which is over 9 percent of the country’s population.

Impact on Diabetes Patients

As Ozempic shortages persist, diabetes patients who have relied on the drug may struggle to adjust to alternatives. Because Ozempic helps manage type 2 diabetes by regulating blood sugar, discontinuing it could cause patients to regain weight and appetite. It also positively impacts blood pressure, so stopping treatment could destabilize levels.

Ending Ozempic could trigger cascading health issues and emotional distress. Many patients report anxiety about being unable to access the medication and concerns about their overall wellness.

These issues already affect Canada’s Indigenous peoples, who experience diabetes at three to five times the rate of non-Indigenous groups, according to the Canadian government.

Families in First Nations communities are reporting shortages and have been told by Health Canada that Ozempic will likely remain unavailable through March 31, 2024.