Is it ethical to take the diabetes drug Ozempic when you don't have diabetes?

System · January 19

This discussion was created from comments split from: 2024 semaglutide (ozempic/wegovy) support.

chris_in_cal · January 14

I was on a plane today, the guy next to me (age 66) was trim and fit. To make small talk I asked him "how do you stay so trim and fit."

He went off.

He started Ozempic last year and lost 50 lbs., his son lost 60 lbs., he described it as a miracle drug. His blood pressure and lipids have normalized.

It was completely unexpected...but he was zealous and happy.

He made a good point, if my healthcare won't cover it, isn't it worth $1000/month to get to a fit weight?

I am seeing my doctor in a couple weeks, we'll see what they say.

sollyn23l2 · January 14

chris_in_cal wrote: »

I was on a plane today, the guy next to me (age 66) was trim and fit. To make small talk I asked him "how do you stay so trim and fit."

He went off.

He started Ozempic last year and lost 50 lbs., his son lost 60 lbs., he described it as a miracle drug. His blood pressure and lipids have normalized.

It was completely unexpected...but he was zealous and happy.

He made a good point, if my healthcare won't cover it, isn't it worth $1000/month to get to a fit weight?

I am seeing my doctor in a couple weeks, we'll see what they say.

Theoretically if you have the money for it, sure. For me, 1000 would be 1/3 of my paycheck. I wouldn't be able to pay rent. But, if you have the money and you won't miss it, then yeah, it could definitely be worth it.

kshama2001 · January 15

chris_in_cal wrote: »

I was on a plane today, the guy next to me (age 66) was trim and fit. To make small talk I asked him "how do you stay so trim and fit."

He went off.

He started Ozempic last year and lost 50 lbs., his son lost 60 lbs., he described it as a miracle drug. His blood pressure and lipids have normalized.

It was completely unexpected...but he was zealous and happy.

He made a good point, if my healthcare won't cover it, isn't it worth $1000/month to get to a fit weight?

I am seeing my doctor in a couple weeks, we'll see what they say.

Chris, if you have Type 2 Diabetes, that's what Ozempic is FDA approved for, and in that case I can't imagine that your healthcare won't cover it. If you do have T2 diabetes but they don't cover it, fight it for sure.

All those who don't have Type 2 diabetes but get semaglutide is causing shortages. One PP's Walgreen's was out. (They didn't mention having Type 2 Diabetes or not.) The PP whose CVS was out did mention a glucose monitor.

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

chris_in_cal · January 15

kshama2001 wrote: »

Chris, if you have Type 2 Diabetes, that's what Ozempic is FDA approved for

Hello @ksharma2001 hasn't the FDA approved Wegovy for obesity treatment, and isn't this identical to Ozempic except for dosage?

I don't have an MBA but the manufacturers of semaglutides get shipped to either of the two drugs makers.

I know scolding people who are using ozempic off-label for weight loss kind of makes sense, I get it. There does seem to be significantly larger issues at play.

sollyn23l2 · January 15

chris_in_cal wrote: »

kshama2001 wrote: »

Chris, if you have Type 2 Diabetes, that's what Ozempic is FDA approved for

Hello @ksharma2001 hasn't the FDA approved Wegovy for obesity treatment, and isn't this identical to Ozempic except for dosage?

I don't have an MBA but the manufacturers of semaglutides get shipped to either of the two drugs makers.

I know scolding people who are using ozempic off-label for weight loss kind of makes sense, I get it. There does seem to be significantly larger issues at play.

They weren't scolding you. They were saying if you have type 2 diabetes, that's a way to get your insurance to pay for it. Because it's, you know, expensive.

kshama2001 · January 15

chris_in_cal wrote: »

kshama2001 wrote: »

Chris, if you have Type 2 Diabetes, that's what Ozempic is FDA approved for

Hello @ksharma2001 hasn't the FDA approved Wegovy for obesity treatment, and isn't this identical to Ozempic except for dosage?

I don't have an MBA but the manufacturers of semaglutides get shipped to either of the two drugs makers.

I know scolding people who are using ozempic off-label for weight loss kind of makes sense, I get it. There does seem to be significantly larger issues at play.

I'll save the discussion of the ethics of people who don't have diabetes using a diabetes drug off-label and causing shortages for people who do have diabetes for the Debate forum

But yes, Ozempic is FDA approved for diabetes and Wegovy for obesity.

There was at least one poster earlier in the thread who mentioned not losing weight despite taking a semaglutide. I noted the bolded for those in that situation:

https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss

There are currently three FDA-approved semaglutide products:

Ozempic injection and Rybelsus tablets are approved to lower blood sugar levels in adults with type 2 diabetes mellitus, in addition to diet and exercise. Ozempic is also approved to reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes mellitus and known heart disease.
Wegovy injection is approved to help adults and children aged 12 years and older with obesity or some adults with excess weight (overweight), who also have weight-related medical problems, to lose weight and keep the weight off, in addition to diet and exercise.

chris_in_cal · January 16

kshama2001 wrote: »

I'll save the discussion ...for the Debate forum

As you brought it up, and I wrote that I see your point, I don't think you and I would debate.

I question the popular notion that rich thin people are ripping meds from poor diabetics hands. I'm just not seeing that the U.S. Healthcare industry, and global pharmaceutical behemoths are anything other than overjoyed with how this is playing out. Off label use by some isn't substantially impacting their business model or preventing them from doing business.

kshama2001 wrote: »

There are currently three FDA-approved semaglutide products:
Ozempic injection

Wegovy injection.

These are the same drug, same method of administration, and different doses. Which dosage and target population brings the biggest profit for the manufacturer. Shareholders demand they maximize profit.

Thanks, I didn't realize Rybelsus was a semiglutide. I don't know much about it.

I am always reminded of that important blood pressure med viagra that just took off with a life of its own in a way the manufacturers did not forsee.

kshama2001 · January 18

chris_in_cal wrote: »

kshama2001 wrote: »

I'll save the discussion ...for the Debate forum

As you brought it up, and I wrote that I see your point, I don't think you and I would debate.

I question the popular notion that rich thin people are ripping meds from poor diabetics hands. I'm just not seeing that the U.S. Healthcare industry, and global pharmaceutical behemoths are anything other than overjoyed with how this is playing out. Off label use by some isn't substantially impacting their business model or preventing them from doing business.

kshama2001 wrote: »

There are currently three FDA-approved semaglutide products:
Ozempic injection

Wegovy injection.

These are the same drug, same method of administration, and different doses. Which dosage and target population brings the biggest profit for the manufacturer. Shareholders demand they maximize profit.

Thanks, I didn't realize Rybelsus was a semiglutide. I don't know much about it.

I am always reminded of that important blood pressure med viagra that just took off with a life of its own in a way the manufacturers did not forsee.

The FDA reports a national shortage. The VA will not write new prescription for Wegovy citing the national shortage. There's a shortage.

Oh, I just saw you wrote "rich thin" - why would thin people be taking a weight loss drug? Do you mean rich people who want to lose vanity pounds? Anyway, "rich thin" people weren't part of this discussion prior to you bringing them up.

chris_in_cal · January 19

you wrote "rich thin" - why would thin people be taking a weight loss drug?

Movie stars and public figures have been scapegoated for causing an international shortage.

Where is the FDA national shortage of meds data you referenced? The manufacture wrote this month that "We are actively producing and shipping all dose strengths into the U.S. market at this time." and yes there is a very high demand and manufacturing being ramped up even more is their main work. They have dump trucks of cash available to them to ramp up however they can.

Though as I wrote elsewhere a dose of semiglutide being manufactured, and a patient walking around with a prescription isn't a complete picture. This medical treatment is bound up with the horrific US healthcare system and all the various competing factions.

In November 2023 the US FDA approved a second manufacture to provide obesity GLP-1 meds. "Zepbound" which is the different dose of Mounjaro (tirzepatide) Eli Lilly's dose that's was approved for diabetics. The "short supply" of the original manufacturer may be much less of an issue if there is a direct competitor.

kshama2001 · January 21

chris_in_cal wrote: »

you wrote "rich thin" - why would thin people be taking a weight loss drug?

Movie stars and public figures have been scapegoated for causing an international shortage.

Where is the FDA national shortage of meds data you referenced? The manufacture wrote this month that "We are actively producing and shipping all dose strengths into the U.S. market at this time." and yes there is a very high demand and manufacturing being ramped up even more is their main work. They have dump trucks of cash available to them to ramp up however they can.

Though as I wrote elsewhere a dose of semiglutide being manufactured, and a patient walking around with a prescription isn't a complete picture. This medical treatment is bound up with the horrific US healthcare system and all the various competing factions.

In November 2023 the US FDA approved a second manufacture to provide obesity GLP-1 meds. "Zepbound" which is the different dose of Mounjaro (tirzepatide) Eli Lilly's dose that's was approved for diabetics. The "short supply" of the original manufacturer may be much less of an issue if there is a direct competitor.

@chris_in_cal, re the bolded from your post above, I provided this earlier. If you were looking for something different, please clarify.

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

There clearly isn't enough supply to meet demand. There could be multiple reasons. Sure, the manufacturer could be keeping supply unnecessarily low. But meanwhile, since there is a shortage, I believe it is unethical to request the form approved for diabetics when one does not have diabetes.

chris_in_cal · January 21

kshama2001 wrote: »

I believe it is unethical to request the form approved for diabetics when one does not have diabetes.

Got it. And @System harmonized with your positioning this as a personal ethics stand, by titling this new thread as such.

Okay, I see what you wrote.

The personal ethics a patient has when making decisions to address their own individual health is a good topic. You stated your thoughts on those ethical stands. Got it.

I googled typical medical ethics issues, there was a big survey of physicians that's published on medscape.

Should physician-assisted suicide be allowed in some situations?
Yes - 45.8%

No - 40.7%

it depends - 13.5%

Physicians are split on many different big ethical issues. Differing thoughts on medicine happens as it is an art practiced by humans, as opposed to an algorithm based on some mathematical proof.

AnnPT77 · January 21

People taking a drug for specious, trivial or selfish reasons, when other people need the drug for a serious health condition, is poor personal ethics. I agree with kshama.

I'm not talking about people who need a GLP-1 drug for a serious health condition (obesity) and take a drug off-label that's the same drug marketed for a different health condition (diabetes). I'm talking about people who are fatter than they might prefer, but who aren't obese to the point of body weight being a health threat.

Is this a main cause of the shortage? I have no idea. If there weren't a shortage, I wouldn't fuss about the ethics of less-necessary use, though.

If the manufacturers had forecast the demand accurately, I have a pretty strong sense that they would've ramped up manufacturing faster if possible. There's more to increasing drug production than throwing cash at the problem.

The price of a novel new drug tends to be high in our questionably-structured US system, but its price is not IMO all that responsive to demand levels. The price may be artificially high, but not because of high demand or shortages at this point. Certainly, if some sub-markets are willing to pay cash out of pocket, that will distort where the existing supply is allocated in a time of shortage.

sollyn23l2 · February 9

chris_in_cal wrote: »

kshama2001 wrote: »

I believe it is unethical to request the form approved for diabetics when one does not have diabetes.

Got it. And @System harmonized with your positioning this as a personal ethics stand, by titling this new thread as such.

Okay, I see what you wrote.

The personal ethics a patient has when making decisions to address their own individual health is a good topic. You stated your thoughts on those ethical stands. Got it.

I googled typical medical ethics issues, there was a big survey of physicians that's published on medscape.

Should physician-assisted suicide be allowed in some situations?
Yes - 45.8%

No - 40.7%

it depends - 13.5%

Physicians are split on many different big ethical issues. Differing thoughts on medicine happens as it is an art practiced by humans, as opposed to an algorithm based on some mathematical proof.

Yes, there are as many ethical opinions as there are people. Ethics are personal and not really based on facts. Many doctors believe it's perfectly moral to provide a herion addict with opiates. That's why patients "doctor shop" Some doctors feel it's perfectly moral to perform a life threatening operation on someone who doesn't need it because the patient requested it (some plastic surgeries). Some people and doctors feel it's ok to kill an unborn baby, others feel it's ok only in certain circumstances, other people believe it's never ok. Same thing with optional medications. You're always going to find people who believe you are a bad person due to your choices. They will always believe that about you. To try and change their mind is a waste of time. Accept that some people will believe you are bad for your choices, and move on. It doesn't matter what they believe about your morals. It matters what you believe. And the fact that you continue these discussions indicates that maybe you're not so sure what the moral choice is. But no-one else can decide that except you.

chris_in_cal · February 9

sollyn23l2 wrote: »

And the fact that you continue these discussions indicates that maybe you're not so sure what the moral choice is

I was in a conversation regarding the ethics of the US pharmaceutical industry and it's profit incentive, and it morphed and was relocated here as a personal ethics subject.

BTW: This week Novo announced a new 16.5 billion U.S. manufacturing contract, and an 11 billion acquisition purchase of three US manufacturering plants. Because they have dump trucks of cash coming in every hour. [Novo share price went up 4% after the announcement] It's nice they waited until their competitor's Zepbound received FDA approval for use with obesity. Thus personal ethics is an issue, an important issue, and one that skews toward zero here on whether it affects other ill patients who need to receive pharmacological treatment.

Lastly

the fact that you continue these discussions

I haven't commented on this topic since it was relocated here a couple weeks ago and the subject line was changed to frame it as a personal ethic problem. What ongoing discussion are you talking about?

sollyn23l2 · February 10

chris_in_cal wrote: »

sollyn23l2 wrote: »

And the fact that you continue these discussions indicates that maybe you're not so sure what the moral choice is

I was in a conversation regarding the ethics of the US pharmaceutical industry and it's profit incentive, and it morphed and was relocated here as a personal ethics subject.

BTW: This week Novo announced a new 16.5 billion U.S. manufacturing contract, and an 11 billion acquisition purchase of three US manufacturering plants. Because they have dump trucks of cash coming in every hour. [Novo share price went up 4% after the announcement] It's nice they waited until their competitor's Zepbound received FDA approval for use with obesity. Thus personal ethics is an issue, an important issue, and one that skews toward zero here on whether it affects other ill patients who need to receive pharmacological treatment.

Lastly

the fact that you continue these discussions

I haven't commented on this topic since it was relocated here a couple weeks ago and the subject line was changed to frame it as a personal ethic problem. What ongoing discussion are you talking about?

The one you're in right now. I wasn't attacking you, simply agreeing, that yes, everyone's ethics are different. So don't worry that someone's ethics disagree with yours. Businesses are amoral. They are not designed to have ethics, they're designed to make money. Even the ones that claim otherwise.

PAV8888 · February 10

**I am SOOOOO confused as to the multitude of turns this thread has taken. So many threads die or get buried. This one seems to be magically morphing to stay around!**

I suppose if a person was dying next to me because I was denying them a drug that I was taking for non dying reasons I may well feel uncomfortable and morally bankrupt.

There is a lot of *kitten* happening in the world and the fact that I am on MFP "spouting" instead of putting that time towards a more "worthwhile" cause could also be construed as lack of morality.

There are a LOT of ways available to treat type 2 diabetes. Starting from non pharmacological management and ending in pharmacological management performed by a LOT of drugs in addition to the new GLP ones. MOST of them are not in short supply so I don't buy in to the belief that a lot of diabetics are getting permanently harmed.

The fact that a drug is labeled for one use and is being used for another does not create moral bankruptcy to the off label user.

Taking it trivially and without really needing to... WOULD be a minus towards my evaluation of the person doing so and towards the evaluation of their provider.

But that would apply equally to the population that is using it for the labeled and the unlabeled use.

chris_in_cal · February 10

sollyn23l2 wrote: »

they're designed to make money. Even the ones that claim otherwise.

Yup.

paperpudding · February 15

There is a shortage in Australia too and pharmacists have been advised to prioritise supply to diabetics on PBS scripts over weight loss patients on private scripts.

I think non diabetic patients, unless morbidly obese, should refrain from taking supply from those who medically need it and doctors should likewise refrain from writing private scripts.

If supply catches up with demand then it won't matter but at the moment it does.

PS yes of course most diabetic meds are not in short supply but Ozempic and co aren't for diabetics achieving good BSL control on their current medications so that is moot point really.
Most weight loss options aren't in short supply either.

PAV8888 · February 16

paperpudding wrote: »

I think non diabetic patients, unless morbidly obese, should refrain from taking supply from those who medically need it

FIFY

I agree that people who medically need these drugs should get first dibs. Regardless as to WHY they medically need them.

I am NOT convinced that (world-wide) only "last resort" diabetics are getting the prescriptions--so probably NOT a moot point to accept that this is the true situation. Any more so than I am convinced that only "last resort" weight loss patients are getting them.

The allocation issue is also probably getting further complicated by short and long term business considerations of competing drug manufacturers and of their internal units and departments.

sollyn23l2 · February 16

PAV8888 wrote: »

paperpudding wrote: »

I think non diabetic patients, unless morbidly obese, should refrain from taking supply from those who medically need it

FIFY I agree that people who medically need these drugs should get first dibs. Regardless as to WHY they medically need them.

I am NOT convinced that (world-wide) only "last resort" diabetics are getting the prescriptions--so probably NOT a moot point to accept that this is the true situation. Any more so than I am convinced that only "last resort" weight loss patients are getting them.

The allocation issue is also probably getting further complicated by short and long term business considerations of competing drug manufacturers and of their internal units and departments.

Yup. Agreed. I'll say that since Weight Watchers is now preparing to hand out ozempic like candy, it's safe to say it's not being used as a last resort.

Is it ethical to take the diabetes drug Ozempic when you don't have diabetes?

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