POWHATAN, Va. (WRIC) — Pat Key has lived in central Virginia for 29 years, and like many in her family before her, she suffers from Type 2 diabetes. Over the past two years, it’s become much easier to manage thanks to a new drug — but now, the supply has suddenly dried up.
Speaking with 8News on Wednesday, Key said, “my parents, my grandparents, my great-grandparents” all had type 2 diabetes. She’s accustomed to the twice-daily routine of pricking her finger to monitor her blood sugar, and until this week, her levels had been rock steady.
That’s thanks to Trulicity, a drug sold by Eli Lilly that’s administered once a week by injection, and since it was approved to treat diabetes in 2014 has been prescribed to millions of diabetics.
But when Key went to get her monthly refill at the end of November, she was told there was none to be found.
“It was supposed to be refilled Monday, and it was out of stock,” she said.
When she asked the pharmacist to check other locations, she was told there was no Trulicity in stock at any of the pharmacies within 20 miles. When she asked if it would be replenished soon, the pharmacist told her she had “no idea when their next shipment will come in.”
One of the big factors driving the shortage of Trulicity is a chain of other shortages in related medications, causing a cascade of demand.
One competing diabetes medication, Ozempic, is currently under a shortage according to the FDA, and although the drugs are not identical, they are both used to treat type 2 diabetes, and an Eli Lilly executive told industry outlet Fierce Pharma that competitor Novo Nordisk’s supply problems had spurred a spike in demand for Trulicity.
When reached for comment, Eli Lilly told 8News that “the strong global demand for Trulicity, amplified by global competitor incretin shortages, is resulting in potential short-term delayed delivery and restocking of supply of Trulicity at some wholesalers.”
One potential reason for the sudden shortfall of Ozempic? A newly popular, off-label use as a weight loss drug.
Indeed, Ozempic is actually sold by Novo Nordisk under another name — Wegovy — as a tool for weight loss. Dr. Lauren Pamulapati, an assistant professor of pharmacology at VCU and active practitioner at the Hayes E. Willis Health Center, said that’s what led to the current shortage.
“People started using Ozempic because the other medication went on backorder,” she said.
When Ozempic itself went on backorder, many turned to Trulicity and Mounjaro, a similar medication also sold by Eli Lilly. While neither is currently FDA-approved for weight loss, they can be prescribed for it “off-label” by doctors.
Indeed, the drug was found during trials to greatly reduce users’ desire to eat — a factor that made it useful for diabetics, who often benefit from weight loss. One factor driving the current surge in popularity is a social media trend, but physicians say the responsibility rests on doctors to prescribe the drug responsibly.
Trulicity, Ozempic and Mounjaro are all readily available through online retailers touting them as weight loss solutions. One, Nextmed, advertises them alongside other common diabetes medications for $100 a month — and offers shipping straight to customers’ homes.
There may be some relief on the horizon, as Eli Lilly said that with new manufacturing, “we expect to double Lilly’s incretin capacity by the end of 2023.”
But in the meantime, the company will simply continue managing a “tight supply.”
Key said she was disappointed to see a shortage hit a vital medication like Trulicity.
“I would hope Eli Lilly would be ready for this,” she said.
If it Happens Again…
Just a few hours after 8News first spoke with Key, she managed to find a new supplier for her Trulicity through her employer. But it came with a $40 catch.
Key normally pays a $25 copay at her local pharmacy, but the new source, which will ship it directly to her, is asking $65 for the same number of doses. And although her 4.5 mg dosage was available, she said even this company was out of the 3 mg doses.
The inconsistency of that supply is no small matter for Key. In the few days since her supply ran out, she’s already experienced consistently higher blood sugar levels and the fatigue that comes with it.
But her real concern is for the long-term effects of elevated blood sugar, which could include permanent damage to her organs.
“If my blood sugar were to spike, I could go blind or have a stroke,” she said.
Pamulapati offered reassurance for patients who are facing difficulty getting their refill, saying that as long as they closely monitor their blood sugar levels, a short break from the medication shouldn’t be dangerous.
She also offered advice for patients worried about their own supply.
First, “fill as early as possible” — that means calling the pharmacy as soon as you use your last dose. Even if they aren’t able to fill the prescription immediately, that will give the pharmacy a week to find the medication.
Second, talk with your doctor. “Let them know if you had a delay in your medication,” she said.
That will give them a chance to adjust your other medications if necessary and help you identify other potential sources for the medication.
Finally, she added that there are alternatives that aren’t facing the same supply restrictions, such as a daily injection option.