Professor John Dixon, a world leader in obesity medicine, questions prioritizing treatment of diabetes over obesity. “If Ozempic works better than any other drug, why is Ozempic’s use in obesity questionable?
“Drugs for diabetes have been around for decades, and there are several new ones. We have seen dramatic improvements in the health and well-being of people living with diabetes. had a golden hour.
“But obese people, even the most severely obese, have no access to PBS-registered drugs. What they have is access to bariatric metabolic surgery in public hospitals. It’s just that access is very low.
“In Australia today, 94% of this surgery is performed in private hospitals. Therefore, very few people with clinically severe obesity have access. I mean
“More than one million Australians have clinically severe obesity and would be eligible for priority bariatric surgery. is.”
Ozempic pen. Sipa USA
He said pharmaceutical companies know diabetes drugs are more likely to get approval than obesity drugs. The same bias applies to government agencies that decide whether drugs should be subsidized.
“There has never been an obesity management drug in Australia’s PBS,” says Dixon, of the Iverson Health Innovation Institute at Swinburne University in Victoria.
He said people have a hard time accepting that obesity is a serious disease and not the result of personal indulgence. Affects major organ systems, joints and mental health.
“But we ignore the risks of cancer, heart disease and disability in people who are clinically obese.”
structure
Ozempic is a non-insulin drug designed to improve blood glucose levels in adults with T2 diabetes. Its main mechanism is significant weight reduction.
Its active ingredient, semaglutide, works by inducing satiety. This feeling of satiety or “satiety” suppresses appetite, leading to less food intake and weight loss.
“Drugs approved for obesity in the last decade are not as effective as semaglutide and have more side effects,” says Dixon. says Mr.
“The world loves these drugs, but the companies that made them just didn’t have the capacity to make what the world needed. Most supplies go to the United States, where prices are higher than here. You can put a price on it.”
According to PBS, Ozempic costs about $42 a month (four injections per week) for Australians. A personal prescription costs about $132 per month.
According to medical news website WebMD, using Ozempic could cost uninsured Americans more than $1,000 a month, with many flocking to Canada to save $700 a month. Danish multinational Novo Nordisk, which manufactures the drug, offers a price sale on its website.
demand from healthy people
From left: Professor Jonathan Shaw, Associate Director of the Baker Heart and Diabetes Institute. Professor John Dixon, world leader in obesity medicine. Gary Whittart, Professor of Medicine, University of Adelaide. Professor Jerry Greenfield, Head of Endocrinology and Director of Diabetes Services, St. Vincent’s Hospital, Sydney.
Another factor affecting supply is use by healthy people who want to lose a few kilos to feel and look better. Experts say the shortage will not only get worse, it could also damage health.
“They don’t realize that they may be compromising their health,” says Gary Wittart, a professor of medicine at the University of Adelaide and senior consultant endocrinologist at the Royal Adelaide Hospital. Although this drug is very effective in inducing fat loss, lean tissue is also lost.
“They are robbing Peter to pay Paul. he says. “This is medicine for people with serious health problems and should be used as such.”
The long-term effects of this muscle and bone loss are still unknown. Clinical trials will give him five years of data, and registry data will give him more, but it’s not yet clear what will happen in 20 years.
“From a nutritional standpoint, if these people are eating suboptimal diets, they are not getting the right nutrients. Wittart says. “For example, if you’re driving a Maserati and you put an ethanol mixture in the car and the car doesn’t run very well, reducing the amount of ethanol mixture won’t help the situation.
“There will not be enough drugs in the world to treat everyone who thinks they are overweight,” Wittart said.
“The drug is fairly well tolerated, but it can cause gastrointestinal side effects such as nausea, loose stools and regurgitation,” he added. “Because gastric emptying slows down, ingested food is not propelled forward at the same rate and can cause reflux.
But when the drug is used to treat T2 diabetes and severe obesity, Wittart said its effects could be “life-changing.”
It targets relevant biology to lower blood sugar, reduce weight, and control food intake in people who are incapable of feeding themselves.
“The starting point is still optimizing basic health-related behaviors such as normalizing sleep, eating wisely, and strength training to maintain muscle mass,” he says. “When you add medicine to this holistic approach, it solves an intractable problem.
victim of one’s own success
Professor Jerry Greenfield, Director of Endocrinology and Director of Diabetes Services at St. Vincent’s Hospital in Sydney, says semaglutide’s ability to promote weight loss and improve diabetes control is a victim of semaglutide’s own success.
“Supply issues that led to the unavailability of semaglutide and later dulaglutide (another once-weekly injectable formulation) have affected the potency of this class of drugs to induce appetite suppression and satiety in people with and without diabetes. The result.
“Before these drugs were launched, treatment options for weight loss were very limited,” he says. “Over the past year or so, it has been very difficult to procure semaglutide. Availability has increased in recent months. Should be restricted to persons previously treated with semaglutide.
“Some patients who were previously using semaglutide or dulaglutide will need to start other treatments for their diabetes or transition to daily injections such as liraglutide, which is not subsidized by PBS and is only available by private prescription. Some people have
He has experienced shortages of other medications from time to time, but I don’t remember seeing a shortage of T2 diabetes on this scale.
However, similar agents are being developed that alleviate the supply problem. One is a new class of diabetes drug called Mounjaro. Ozempic activates one of her hormone receptors. Munjaro activates the same hormone receptor and another related receptor.
It was approved for use by the TGA in December, but manufacturer Eli Lilly has yet to announce when it will be available and available in Australia. A triple His agonist that stimulates three receptors is also in development.
An oral version of the drug is also in development, and research is underway to see if semaglutide can act on the brain’s reward circuits to help curb obsessive-compulsive and addictive behaviors.
As social media influencers continue to tout Ozempic as a miracle weight-loss pill, the TGA continues to warn consumers about illegal alternatives while waiting for the shortage to end by July.
Novo Nordisk says it is working hard to make Wegovy available to patients
We aim to coexist with obesity as soon as possible, but we have not yet confirmed when it will be available in Australia.
