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Comment by cflewis | Hacker News Reader

I know someone prescribed for Wegovy/Ozempic for over a year now and has not managed to find any supply at all.

I think a big problem is that pharmacists have to be sure they can _continue_ giving it to a new patient.

The starter doses are hard to find. The larger doses are not. It depends on if your friend is trying to use insurance or not, but if they’re going out of pocket tell them to ask their doctor about prescribing the Ozempic 8mg pen and just using a click chart to dispense smaller doses. The upshot is the pen will last multiple months until you’re past 1mg dosage. I wonder when our big pharma overlords will close this option.

If they’re waiting for Wegovy because it’s covered by insurance, unfortunately the pen is fixed dose on those.

Also, the supply constraint seems to be the injector pens, not the drug itself. Personally, I think the scarcity is intentional, or we'd be getting this stuff in vials and using regular syringes. Unless I'm misinformed, I don't think there's any bottleneck in the manufacture of semaglutide itself.

> Also, the supply constraint seems to be the injector pens, not the drug itself. Personally, I think the scarcity is intentional, or we'd be getting this stuff in vials and using regular syringes. Unless I'm misinformed, I don't think there's any bottleneck in the manufacture of semaglutide itself.

Almost certainly the case. I get semaglutide in a monthly vial for $250/month (off insurance). They provide regular syringes & wipes, but also recommend you order some spare in case any of the needles break (they are super thin). I know someone else getting Wegovy on insurance, and it's all pre-drawn injectors.

> The starter doses are hard to find. The larger doses are not.

My friend's experience was the opposite. When she moved to the higher doses, CVS was often unable to get it in, and she's had to ask her provider put in orders for the lower doses a few times because that was what they could get. I don't know specifically what does she's on though (I swear she said 7.5 once, which is close to the 8 you mention).

Could you share how you get semaglutide in a monthly vial for $250/month (off insurance?

because he's getting it from a compounding pharmacy who are buying the molecule from a random chinese peptide factory

Compounding pharmacy like Hims.com sells it for $200/mo if you pay a year upfront. Else it's $400 month to month.

They ship you some vials and a syringe. The name brand Ozempic just comes in autoinjector form like an epipen.

As others replied, compounding pharmacies. I'm using orderlymeds, but there's a number of different ones. There's no "generic" version of Wegovy, but compounding pharmacies can read the ingredients and make it themselves, at least while the FDA lists it as being in short supply.

You do need to research though (dropping two articles below). Orderly uses Hallandale pharmacy out of Florida., in fact a lot of the online clinics do. As an example, several clinics (such as Henry Meds) was selling "sodium semaglutide" (aka salt semaglutide) ordered through Hallandale that didn't really work for lots of people and there's lots of mix reviews based around that - not everyone was aware of what version they were getting. Also - not everyone is going to properly measure their dosage, which is why the pre-filled injectors the Novo brand provides is important.

FDA Article: https://www.fda.gov/drugs/postmarket-drug-safety-information... NPR Article: https://www.npr.org/sections/shots-health-news/2024/06/07/g-...

You can't order from the pharmacy directly, you need to go through a clinic to get a prescription and have it ordered, but this is the price the clinics pay, before they add their services on top of it.

https://partner.hallandalerx.com/pricing/2024-glp-1-pricing-...

> My friend's experience was the opposite. When she moved to the higher doses, CVS was often unable to get it in, and she's had to ask her provider put in orders for the lower doses a few times because that was what they could get. I don't know specifically what does she's on though (I swear she said 7.5 once, which is close to the 8 you mention).

Ah that's unfortunate. I guess I shouldn't have concluded my experience was true everywhere. My insurance (PPO from a tech co) doesn't cover Wegovy even with approval (my PPO from a prior tech co did), so my doctor suggested that since I'm going out of pocket and I'm not at the max dose, going with the Ozempic 8mg pens but dialing less than the max would let me stretch it out further. If she's on Wegovy and paying out of pocket, you might pass along this info regarding Ozempic. This assumes she's not at the max dose, though. If she is, it's not cheaper.

Of course I know him - he's me.

I am a 44 year old who has already had a heart attack (prevalence of Lp(a), not directly lifestyle related), but I am 30ish pounds overweight. My GP and my cardiologist both want me on Wegovy, but my insurance won't cover it. Fortunately, I'm spared from paying $1,000/mo by not being able to find it even if I wanted to.

I was in Mexico last year and every single pharmacy had it (including all 12+ of them in the airport in Puerto Vallarta)... not sure if it was legit though as some of the pharmacies have been caught with counterfeit product.

9/10 that's counterfeit.

There is no shortgage of semaglutide but there is a shortage of the delivery method. IIRC most of the hit drugs like viagra or ADHD medicine had a high chance of being just meth when bought from a pharmacy in Mexico.

viagra is dirt cheap to manufacture, i cannot believe it's commonly swapped with meth of all things, which is also a vasoconstrictor and therefore gives you the opposite intended effect

I should have been clearer. I would most definitely not trust a large number of pharmacies in Mexico. I am sure there is probably a way to get it with a high certainty of quality but in general a lot of drugs are plagued with what I assume to be cartel control. I have seen studies like this in more recent history where they test the purity of Xanax/Adderall/Oxy and there is a decent chance its not pure. I suspect they are not putting meth/fentanyl in viagra but I would find it likely many of the popular tourist drugs are not pure and would not surprise me what they are mixing in with it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901047/

If the atoms in the organic molecule are in the correct place and there isn't much fentanyl or lead in the vial, I'm 100% ok with side-stepping patents and using counterfeit. Or another name I'd use is "market efficiency".

No, generic Viagra/Cialis are just super cheap drugs that Americans overpay for.

28 pills Tadalafil (Cialis) = $30

https://www.farmaciasguadalajara.com/tadalafil-5-mg-28-table...

Amphetamine is hard to find in stock legally in Mexico and I've never seen shops claiming to sell that kind of pharmaceutical illegally. Meth pills? Sounds like a myth.

Every year Americans go to the border expecting Mexico to have a crazy free for all market for illegal pharmaceuticals and they are always left disappointed. What Mexico is good for are cheap over the counter versions of drugs that are annoying to get in the US like birth control (and dick pills) for no good reason.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901047/

Disagree, there have been a number of reports of the popular tourist drugs not being pure. In the case of Xanax/Adderall type drugs, they have found Fent/Meth in them. There are a few studies/reports like this over recent history. If the cartel is wanting to control avocados, why not create counterfeit drugs that are not pure?

There are definitely many pharmacies that advertise these types of drugs with a handy doctor to write a Rx if its needed.

How have you been managing your high cardiac risk so far? (Just curious. I know of new drugs to lower Lp(a), but have no experience with them.)

Statins to control the "normal" cholesterol levels (which weren't bad to begin with), and I've found that my Lp(a) number went down a little after I started CoQ10, which is something that's been found in experimentation as well - https://pubmed.ncbi.nlm.nih.gov/26836888/

I keep trying to get into one of the Cleveland Clinic trials for the drugs that rewrite your liver's instructions to prevent it from making Lp(a), but I haven't had much success with timing so far. If I do get into one of those trials, I want to get a tattoo with a "Genetically Modified Organism" logo :-D

I felt good at the end of last CY when I was able to get it filled in 3 month increments.

where do you get it filled in 3 month increments?

OptumRX

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