Semaglutide Shortage Highlights Inequities in Diabetic Medication Access

Jennifer Middleton, MD, MPH
Posted on January 16, 2023

Semaglutide (sold under the brand name Ozempic for treating type 2 diabetes mellitus treatment and Wegovy for treating obesity) has been trending on TikTok, as various celebrities tout its effectiveness for losing weight. Unfortunately, this social media hype has increased demand for semaglutide at the same time that its supply chain has been affected, leaving many patients with diabetes who rely on semaglutide unable to procure their medication. As is the case in so many other facets of health care in the United States, the semaglutide shortage illustrates the gulf between those who can afford to pay out of pocket for it and those who cannot.

Semaglutide was approved by the U.S. Food and Drug Administration last year under the brand name Wegovy for weight loss, with results that seemed promising, especially compared with the rather lackluster long-term results for most patients using earlier generations of weight loss medications. It didn’t take very long before social media was singing semaglutide’s praises:

On TikTok, some videos featuring the hashtag Ozempic have been viewed more than a million times. Medical spas offer the prescription alongside shots of Botox and laser hair removal. Sponsored ads on Google promise weight loss with no exercise or dieting. A plastic surgeon brags on Facebook about using the drug to lose 10 pounds she gained during Covid, and says to call her office to get started.

This heightened interest is leading to shortages that are affecting patients who rely on semaglutide to keep their diabetes under control. For many other patients who potentially could benefit from semaglutide for diabetes treatment, though, semaglutide (and many other newer diabetic medications) are too expensive for them to afford. Without insurance, Ozempic costs upwards of $900 a month, and Wegovy is more than $1,000 a month; with insurance, monthly copays still start at nearly $500 a month. In the United States, “[b]y 2017–2019, total spending on diabetes medications was about $500 to $700 more per year for white Americans with diabetes than for their Latinx/Hispanic or Black counterparts, a disparity of 16 percent to 22 percent.” Having unequal access to the newer classes of diabetes medications, especially the ones that can improve mortality, will almost certainly continue to worsen disparities in diabetes outcomes.

Only 20 states in the United States currently have caps on the cost of insulin and other diabetic supplies; advocating for such a cap in your state, if yours is one of the 30 states without one, is one way family physicians can help to narrow this gap. Family physicians can also emphasize to our patients that health is so much more than a number on the scale. We can empower our patients to push back against the unrealistic societal expectations for bodies (especially for women) that are endlessly peddled by the multibillion dollar weight loss industry.

If you’d like to read more, there’s an AFP By Topic on Diabetes: Type 2, the U.S. Centers for Disease Control and Prevention’s website has resources for advancing health equity in diabetes, and the AAFP’s EveryOne project provides tools to address multiple social determinants of health for our patients and their communities.