Since around mid-July, doctors in Germany have been able to prescribe a new preparation that is intended to make it easier for people with obesity to lose weight. Experts worry about a “grey area market”.
Almost a quarter of a year after the market launch of a new weight loss aid for people with obesity, doctors are reporting some demand in Germany. However, it is not yet possible to quantify how many people are already using the drug “Wegovy”, as inquiries from the German Press Agency revealed.
Several places report temporary delivery bottlenecks or concerns about them. Some experts assume several thousand syringes per week for the German market; the manufacturer itself does not provide any information upon request.
“We as plastic surgeons fear that there are an incredible number of applications in a gray area market,” said Sixtus Allert, plastic surgeon and medical director of the Sana Klinikum Hameln-Pyrmont, referring to “Wegovy” and “Ozempic”. The latter is a diabetes medication that is often mentioned in the same breath as the obesity injection. Both preparations contain the active ingredient semaglutide, but in different doses.
According to the European Medicines Agency (EMA), semaglutide works in the body in the same way as a natural hormone and appears to regulate appetite, among other things. According to the EMA, “Wegovy” should be used in combination with dietary changes and physical activity. The costs are not yet covered by health insurance companies. The manufacturer quoted the pharmacy selling price of a four-week ration for the highest dose (2.4 mg) before the market launch in mid-July as a good 300 euros.
Manufacturer distances itself from trivialization
Because diabetics sometimes find it difficult to get their medication due to the demand from those who want to lose weight, some experts have been speaking out against the use of “Ozempic” outside of the approved area of use (so-called off-label use) for months. On the website of the Danish pharmaceutical company Novo Nordisk it is stated that they expressly recommend prescription medications only within the indications approved by the EMA. We firmly distance ourselves from any form of advertising, social media posts and reports that call for improper use or trivialize it.
According to Allert, the remedies are sometimes touted as a simple way to, for example, lose a few kilos without exercise or diet. “A lot of things happen on the Internet and through colleagues who have few scruples and do things that are not medically justified,” said the board of the Association of German Aesthetic-Plastic Surgeons (VDÄPC).
Warning about counterfeit pens
Authorities in Germany warned about counterfeit “Ozempic” pens at the beginning of October. In Austria, the judiciary assumes that at least five people allegedly received counterfeit diabetes medication from a doctor in Salzburg. Three of them apparently had health problems, a spokeswoman for the Steyr public prosecutor’s office told the German Press Agency. The public prosecutor’s office is investigating the doctor and two leading representatives of two smaller companies that may have sold counterfeit “Ozempic”.
In view of the counterfeits, Allert urgently appealed to only obtain such products from a doctor and with a prescription from the pharmacy, even if this is more expensive than other ways. As an Abda spokeswoman said, no counterfeits have yet appeared in German pharmacies.
Doctor: Significantly interfere with physical processes
Regarding the approach at his clinic, Allert said that “Wegovy” is prescribed in selected cases when asked. “This is about patients for whom it is medically justified.” Patients would then also have to commit to changing their diet and exercising more. The doctor assumes that colleagues in conventional plastic surgery will use the preparations cautiously – also out of respect: “We are talking about a drug that optimizes the insulin effect. We are intervening significantly in the physical processes.” In addition, any side effects from long-term use are still unclear.
General practitioners reported increased demand, said Til Uebel, spokesman for the Diabetes Working Group of the German Society for General and Family Medicine (Degam). “Patients often report off-label therapies from other affected people.” The experience from his own diabetological practice is that people with diabetes in particular ask about the preparations for which there is actually no indication for the active ingredient. It’s also about younger people “who aren’t particularly overweight per se.”
Surgical interventions for obesity may become less common in the future
Susanne Reger-Tan, an expert at the German Society for Endocrinology, reports on interested parties with obesity and sometimes also diabetes. In particular, these are people who have tried to lose weight several times in vain, who are very concerned about the long-term health risks of obesity or who are considering the injections as an alternative to so-called bariatric surgery, such as the insertion of a gastric band.
For patients with obesity, Allert sees the preparations as a possible alternative treatment and as very helpful, provided that the current findings on side effects remain. This could also mean that surgical interventions will be necessary less often in the future for some people affected by obesity. The well-known and common side effects of “Wegovy” include headache, nausea, vomiting, diarrhea, constipation and abdominal pain.