Obese patients say they were scolded, sniffed and laughed at when they tried to get the drug Ozempic as new guidelines for doctors and pharmacists stressed that it is only indicated for the treatment of diabetes.
The drug’s active ingredient, semaglutide, is approved for the treatment of obesity but in a higher dose form. However, Wegovy, a drug that includes the ingredient, is not available in Ireland. As a result, obesity doctors here have been prescribing Ozempic at lower doses to thousands of their patients.
The Medical Council last week issued guidance on Ozempic that said off-label prescribing in an environment of scarcity poses a risk to patients for whom the medicine is indicated.
Since then, obesity groups say patients who used Ozempic to treat their obesity have been told by pharmacists they can no longer receive it, and some have been reprimanded for using a drug that is in short supply.
Rachel, from Meath, said she was irritated and giggled when asked to explain at her local pharmacy what she wanted Ozempic for. She said the pharmacist told her she was taking life-saving drugs from the hands of a diabetic patient.
I felt reprimanded and humiliated and by this point a queue had formed behind me. I was mortified, she said, adding that she left the pharmacy in tears but was able to get her prescription filled elsewhere.
Elizabeth, from Dublin, said she had been refused the drug in her pharmacy in recent months and told to have her GP prescribe Saxenda, a more expensive and less effective drug indicated for obesity.
I told them I am not able to pay any more money monthly for the drugs as I already pay the drug payment plan. They said they can’t do anything; they have to keep it for their diabetic clients, she said.
Judge and jury
Mary, from Dublin, said she experienced snide and dismissive attitudes when she phoned pharmacies trying to refill her prescription of Ozempic because she wanted it to treat her obesity.
I think it’s an unfair position to place pharmacists, where they act as judge and jury, he said.
The Association for the Study of Obesity on the Island of Ireland and the Irish Coalition for People Living with Obesity say the Medical Council’s guidance strikes an alarmist tone and poses a risk to experts prescribing semaglutide to patients with obesity in accordance with the international evidence base and guidelines.
The guidance also implies that people with obesity deserve less care than those living with diabetes and that their clinical need is less significant, the two groups say.
The guidance offered to pharmacists in the Medical Council’s communication carries a significant risk of increasing the prejudice and discrimination that people living with obesity experience in the community.
Pharmacist Sheena Mitchell said her profession is now required to ask patients about the clinical reason for their Ozempic prescription and whether it is diabetes or weight loss.
This is an untenable situation that neither the pharmacist nor the patient is comfortable with. Patients feel ashamed and frustrated and pharmacists are upset that they cannot provide the best patient care.
The Medical Council told the Irish Times that doctors are required by ethical guidelines to use resources appropriately and responsibly.
The statement did not infer (sic) that physicians should not prescribe Ozempic. Rather, its purpose was to raise awareness of supply issues and the need for conscious prescribing.
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