High demand and unpredictable supply have led to a shortage of the diabetes drug Ozempic. The use of foreign gaskets to solve the shortage situation has resulted in very high costs for Folketrygden.
The shortage situation applies to the whole of Europe and is expected to persist in 2024. Ozempic contains the active substance semaglutide and is approved for the treatment of type 2 diabetes.
DMP assesses suitable measures in collaboration with the Norwegian Directorate of Health and Helfo. The work is in the final phase and we will conclude shortly.
See also Lack of Ozempic
Call for doctors and pharmacies
Shortage situations are often resolved by allowing pharmacies to supply foreign packages. The delivery situation for Ozempic is challenging and the costs of using foreign packaging are very high. Although the doctor is allowed to prescribe Ozempic outside the approved area of use, we advise against this in the current shortage situation.
– We are now asking doctors to only prescribe Ozempic to diabetes patients. We also encourage pharmacies to only deliver the medicine for four weeks at a time. At the same time, we expect Novo Nordisk to take its social responsibility and prioritize the production of semaglutide products for diabetes patients, says senior physician Sigurd Hortemo at DMP.
Novo Nordisk produces both the diabetes medicine Ozempic and the slimming medicine Wegovy. Both contain the active substance semaglutide. Although there are supply problems at Ozempic, there is no shortage of Wegovy.
Foreign gaskets
DMP regulates the price of the Norwegian packs, but not when pharmacies and wholesalers import packs from abroad. It is Folketrygden that pays the bill when Norwegian patients receive foreign packs on a blue prescription. Foreign packs have a retail price that is three to seven times higher than the price of packs with a Norwegian marketing licence. This has cost Folketrygden several hundred million kroner in 2023.
– Many patients need healthcare and resources in the healthcare system are limited. With such high costs for a single drug, it is necessary to consider measures, while at the same time ensuring that patients receive the treatment they need, says Sigurd Hortemo.
Approved use on blue prescription
Doctors cannot write Ozempic on a blue prescription for the treatment of obesity. Only diabetes patients are entitled to treatment with Ozempic at the state’s expense. To get medicine on a regular blue prescription, you must have type 2 diabetes and use Ozempic in combination with another diabetes medicine. You must also have tried another less expensive drug first.
It is important that the rules for what is to be financed by the community are followed. Helfo has carried out a check which shows that Ozempic is prescribed on a blue prescription without reimbursement criteria being met. DMP has therefore announced a reassessment of the decision on pre-approved reimbursement, that is to say, we are considering introducing a requirement for an individual application for Ozempic rather than a regular blue prescription.
Alternatives
There are several options for treating obesity. Patients with morbid obesity can receive individual benefits for treatment with Xenical (orlistat) and Mysimba (bupropion and naltrexone). Treatment with Saxenda (liraglutide) and Wegovy (semaglutide) must be paid for by the patient and is only exceptionally covered by individual benefits.
There are also other blood sugar-lowering drugs that work well for diabetic patients. The drug group SGLT-2 inhibitors can be a good option for many. This assessment is made by the doctor.