GLP-1 Agonist Used for Weight Loss Causing Drug Shortages

Date: 06/06/23

Superior HealthPlan providers should be aware that some Glucagon-Like Peptide 1 (GLP-1) agonist medications being prescribed for weight loss are leading to shortages of these medications for patients with type 2 diabetes. Nationally, the GLP-1 agonist market is several billion dollars and currently anticipated to grow at a Compound Annual Growth Rate (CAGR) of 6.48%, during the forecast period of 2022-2027¹.

Semaglutide and liraglutide are GLP-1 agonist medications that are approved for treatment in type 2 diabetes, prevention of cardiovascular disorders in patients with type 2 diabetes, and weight loss. Semaglutide has several formulations: Ozempic (type 2 diabetes), Rybelsus (type 2 diabetes), and Wegovy (weight loss). Liraglutide is available as Victoza (type 2 diabetes) and Saxenda (weight loss).

For the primary treatment of weight loss, a medication such as Wegovy is an option for patients who have struggled to lose weight through diet and exercise alone, have a Body Mass Index (BMI) of 30 or higher, and are willing to use a once-weekly injection long term. However, social media attention has highlighted the use of Ozempic for weight loss as well². Increased demand for Ozempic for weight loss, and a national drug shortage of Wegovy, have caused shortages with Ozempic for patients with type 2 diabetes³.

This trend is surfacing with Mounjaro⁴. Although, semaglutide and liraglutide have formulations that are FDA approved to treat obesity, Mounjaro is only FDA-approved for treatment of type 2 diabetes. Superior retail drug claims  show that from June 2022 to October 2022, Mounjaro requests have increased 127% month over month. Although a majority are approved with the appropriate diagnosis of type 2 diabetes, obesity is also one of the top reasons for requesting the medication and is being denied as an excluded benefit.

Below is a reference chart for GLP-1 agonist medications. Please evaluate your patients to ensure they are utilizing the medications appropriately and as indicated.

*Coverage is determined by formulary restrictions for Ambetter from Superior HealthPlan and Texas Vendor Drug Program for Medicaid and CHIP.

GLP-1 Agonist Uses and Coverage Information

Medication	FDA Approved Indication	Dosing Frequency and Route	Medicaid Coverage *Prior Authorization required for formulary medications	Ambetter Coverage *Prior Authorization required for all medications
Dulaglutide (Trulicity)	Type II DM	Once Weekly SQ Injection SQ Injection	Preferred	Formulary Tier 2
Exenatide, extended-release (Bydureon / Bydureon BCise)	Type II DM	Once Weekly SQ Injection	Non-Preferred (Bydureon BCise Only)	Non-Formulary
Exenatide (Byetta)	Type II DM	Twice Daily SQ Injection	Preferred	Non-Formulary
Liraglutide (Victoza)	Type II DM	Once Daily SQ Injection	Preferred	Formulary Tier 2
Liraglutide (Saxenda)	Obesity	Once Daily SQ Injection	Non-Covered Benefit	Non-Covered Benefit
Lixisenatide (Adlyxin)	Type II DM	Once Daily SQ Injection	Non-Preferred	Non-formulary
Semaglutide (Ozempic)	Type II DM	Once Weekly SQ Injection	Preferred	Formulary Tier 2
Semaglutide (Wegovy)	Obesity	Once Weekly SQ Injection	Non-Covered Benefit	Non-Covered Benefit
Semaglutide, oral (Rybelsus)	Type II DM	Once Daily Tablet	Non-Preferred	Non-Formulary
Tirzepatide (Mounjaro)	Type II DM	Once Weekly SQ Injection	Non-Preferred	Non-Formulary

References:

1. Daedal Research. (2023). Global Glucagon-like Peptide 1 (GLP-1) Market: Analysis By Product (Trulicity, Ozempic, Victoza, Rybelsus and Other GLP 1 Products), By Route of Administration (Injectable and Oral Medication), By Region Size and Trends with Impact of COVID-19 and Forecast up to 2027. Research and Market.
2. Yang A. (2022). National Geographic. What to know about Ozempic, TikTok’s favorite weight loss drug.
3. Wheeler M, PharmD. (2023). Semaglutide Injection ASHP.
4. Farache E. (2023). Independent. The ‘next Ozempic’ became a social media sensation.Then everything changed.