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Comment by bdcravens | Hacker News Reader

Funny enough I'm an actual diabetic and having the hardest time getting my prescription, from my endocrinologist, filled

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I'm on Mounjaro, and I've had similar problems with getting it filled.

The demand must be insane.

Was on the BBC that now people are buying it from the black market to lose weight for beach bodies

South Park just did a whole show on this.

The problem is also that this class of drugs (modified peptides) is produced in a very different way from most drugs (small molecules). When small molecule GLP-1 receptor agonists hit the market the shortage will be over very quickly. There is a lot of capacity to produce small molecules in place already. Many companies are currently racing to bring small molecules to market.

I was talking to someone who’s on a similar medication and they were having an equally hard time getting it filled.

I wonder if the issues fulfilling the orders of the actual drug product or the overly complex (and highly wasteful) drug delivery mechanism.?

Pretty sure they can’t manufacture enough of the drug itself.

Novo Nordisk is running their lines at max capacity and cutting production of some other drugs. I think the last number I saw was new weekly prescriptions are up 3x from Dec 2023.

Unlike Eli Lilly (who use chemical synthesis for Zepbound) they use yeast for synthesis and have decided not to contract out production to protect manufacturing trade secrets which makes ramping up slower, have to wait for their Denmark plant upgrade to come online.

When there are drug shortages, you can have a compounding pharmacy mix up proprietary drugs. I'm not endorsing this in any way, that's between you and your doctor, but bringing it up in case you didn't know of it.

That's useless if you need a specific, very new, and patent protected ingredient. For Ozempic generics, that's at least until 2026 until you can go to Brazil or 2031 if you're in the US [1].

The problem at the core is not like the shortages we have in Germany for basic stuff like general fever and pain medication, that's usually due to other countries just bidding more... for Ozempic, it's that virtually every single person gets blasted with joyful weight loss stories by influencers, demand for it is insane, and Novo Nordisk can't keep up with manufacturing despite the growth of the company being enough to account for the economic growth of the entire country of Denmark [2].

[1] https://en.wikipedia.org/wiki/Semaglutide#Generics

[2] https://www.abc.net.au/news/2023-12-19/ozempic-obesity-diabe...

The FDA allows drugs declared in shortage to be mixed, with slight alterations, by compounding pharmacies. https://www.fda.gov/drugs/human-drug-compounding/drug-compou...

> One of the conditions of section 503A restricts compounded drugs that are essentially copies of commercially available drugs, but FDA does not consider a drug to be commercially available when it appears on FDA’s drug shortages list.

I know for a fact you can obtain compounded semaglutide.

It is actually very easy to obtain compounded semaglutide or tirzepatide right now if you qualify for a prescription and can pay a few hundred dollars a month.

My understanding is some states don’t some do

Not suggesting you, or sibling comment, use this, but posting for awareness: https://www.404media.co/people-in-the-philippines-are-callin...

You can also just order it online on the grey market for a lot cheaper.

And probably just get Tylenol in a different capsule shape.

For many, yes. Due to my high medical expenses and having great insurance, I meet my deductibles and out-of-pocket early each year, so most of my medication has a $0 cost.

Suggestions?

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