(NEWSnet/AP) —Supply problems and insurance complications have made it difficult for people to start and maintain a regimen for Wegovy and similar medication for obesity treatment, according to doctors and patients in U.S. 

People starting on Wegovy have to take injections of gradually increasing strength before they reach the “maintenance” dose, which they continue.

The drug's maker, Novo Nordisk, says that demand has forced it to restrict the supply of initial doses in the U.S. The company also said people who take weight-loss drug Saxenda to expect difficulty filling prescriptions for at least the remainder of 2023.

Another drugmaker, Eli Lilly, has said it expects tight supply until year's end for Mounjaro, a diabetes treatment also prescribed for weight loss.

Finding Wegovy can become a part-time job for patients, said Dr. Diana Thiara, medical director of the weight management clinic at University of California-San Francisco.

Thiara said some have to drive 45 minutes or more to get a prescription filled, a barrier for hourly workers who can’t leave their job and for people without a car.

One of Fitch's patients, Mike Bouboulis, has taken Saxenda, Mounjaro or Ozempic, a Novo diabetes drug with the same active ingredient as Wegovy, since 2019. It became much more difficult for him to find the drugs within the past year, after their popularity exploded.

Refilling a prescription involved calling as many as seven pharmacies.

“They all know what you’re calling for, and they all have the same answer: ‘I don’t know. We’ll see tomorrow,’" said Bouboulis, a 35-year-old small-business owner who lives near Boston.

Pharmacy technician Lizzy Nielsen of West Springfield, Massachusetts, used insider knowledge to start Wegovy earlier this year. She regularly checked drug wholesalers' supply lists each morning, then ordered Wegovy for her pharmacy as soon as she saw it in stock.

“I was really lucky ... because that’s when it was like starting to be constantly back-ordered,” Nielsen said.

People who use weight-loss drugs face coverage complications, too. The federal Medicare program for people age 65 and up doesn’t cover obesity medicine, although some privately run Medicare Advantage or Medigap plans do, according to Novo. Coverage from Medicaid programs varies for people with low income.

Doctors and patients say many insurers have stopped covering Ozempic and Mounjaro outside their approved use for diabetes. Some insurers and employers don't pay for Wegovy. Novo Nordisk offers a form letter on its Wegovy website to help doctors request coverage.

Some insurers require patients to get advance approval or to try other strategies, such as diet changes and exercise. Some require patients to show they’ve lost 5% of their body weight after six months on the drugs to continue coverage. Supply limit makes that a challenge, Thiara noted.

“A lot of patients are not staying on it consistently because they can’t get it,” she said.

About 46% of large U.S. employers cover obesity medicines like Wegovy, according to benefits consultant Mercer. Another 18% are considering it.

In the meantime, patients are realizing they can get medical help and don't have to manage it on their own, said Dr. Deborah Horn, an obesity medicine expert at UTHealth Houston.

“I feel like this is the beginning of the change in obesity care, where we will see every year better and better medications coming to market and people getting their disease under control,” she said. “We're just in the hard part ... right now.”

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