Ongoing Shortages of Diabetes Medication

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The ongoing and unpredictable shortages of diabetes medications, including GLP-1 agonists (such as Ozempic, Trulicity, Victoza, and Bydureon) and the GLP-1/GIP agonist, Mounjaro, continue to be reported. These unpredictable shortages make it difficult to anticipate which medications or doses will be scarce at any pharmacy each week or day.

Tracking medication availability across various pharmacies is impractical for clinical staff. The prevailing understanding is that these shortages stem from increased demand, with no clear timeline for resolution.

 Alison Sigler, Clinical Pharmacist of Community Health Centers of Lane County, provides some guidelines to follow:

  1. Prescribe or refill medications based on the doses available when the request is due.
  2. Patients should inform their providers of any issues they encounter when obtaining their medications.
  3. Encourage patients to request refills at least one week before they run out of medication, allowing time to check pharmacy stock, although availability is not guaranteed.
  4. Patients should promptly contact the clinic if they cannot obtain their medication from their pharmacy.

Dr. Sigler says to be prepared to adjust medication doses. If a lower strength is available, consider decreasing the dose. For example, if a patient takes Ozempic 1 mg weekly but only 0.5 mg pens are available, send a one-month supply of the lower dose to the pharmacy with a note indicating the decrease due to backorder. Next month, consider increasing the dose again if the higher strength becomes available. Otherwise, continue with the lower dose. An alternative diabetes medication may need to be used until the supply normalizes.

If a patient needs to be transitioned to a different GLP1 agonist medication, below are GLP1RA equivalent dosing:

 

Drug Frequency      Equivalent Dosing      
Trulicity   Weekly            0.75mg     1.5mg       3mg       4.5mg           
Ozempic Weekly   0.25mg   0.5mg 1mg 2mg   
Bydureon BCISE   Weekly    2mg
Victoza   Daily    0.6mg   1.2mg 1.8mg