With viral videos pushing the use of a critical prescription medicine as a weight-loss treatment, social media influencers are “bypassing” tight advertising guidelines, causing shortages for patients with diabetes.
The number of scripts issued monthly for the drug jumped sixfold from 2021 to more than 86,000 in December, according to data from the federal Department of Health, in what is thought to be a response to its approval as an obesity treatment in other countries.
Ozempic, which you inject into your stomach once a week, has been hailed as a miracle weight-loss medicine on TikTok, with many people documenting their #ozempicjourney.
On TikTok, the hashtag #ozempic has about 70 million views, while #semaglutide has roughly 7.5 million.
The medicine acts on hunger receptors in the brain and stomach emptying to make you feel fuller, but it’s only approved in Australia for people with type 2 diabetes.
Darcy O’Malley, from Perth, has kept her 24k followers up to speed on her #ozempicjourney on TikTok since she began it three months ago.
David Heffernan, president of the Pharmacy Guild of Australia in NSW, said it was disappointing when films on social media glamorizing prescription-only medications led to panic buying.
“It’s against the law to promote Schedule 4 medications. “It’s supposed to be kept hidden,” he explained.
“I get angry when I see panic buying come up on social media because that’s when we experience drug shortages like we did in the epidemic,” she says.
TikTok and Instagram users have been documenting their weight loss journeys after taking the diabetic medicine Ozempic, with over 76 million views.
The medicine, a weekly injection that helps people with type 2 diabetes manage their blood sugar levels, has been accessible in Australia since 2019. It raises insulin secretion, which leads to a boost in sugar metabolism.
Last month, the Therapeutic Goods Administration issued a joint statement with a coalition of medical groups, including Diabetes Australia, the Australian Medical Association, and the peak bodies for pharmacists and GPs, as well as Ozempic’s maker Novo Nordisk. They suggested doctors to prescribe and dispense Ozempic only to those who have type 2 diabetes that is not well managed.
The declaration forbids doctors from administering Ozempic “off-label,” which means for a drug to be used for a purpose for which it is not approved.
Ozempic is a Schedule 4 drug, which means it’s a controlled substance that can’t be advertised to the general public under TGA regulations.
The code exists to ensure that drug advertising is socially responsible, only supports quality usage, and does not mislead or deceive – but it is broad in scope. When influencers in commercial ties promote a drug because of a business relationship, the TGA’s standards clearly include it.
According to Heffernan, unpaid influencers’ social media posts could result in diabetic people missing out on their medications.
“With social media expanding the medicine’s popularity, everyone [is] saying at coffee shops, ‘Jeez, you’ve got to get on this pill, I lost five kilograms in two weeks.'”
Pam Sack, a pharmacist at Bondi Pharmacy, said she first noticed a spike in customers buying the medicine in December. The number of scripts filled each day “doubled and tripled” between February and April.
She is no longer available. “Off-label prescribing has exploded; they weren’t prepared for the massive demand.”
She said she had filled Ozempic prescriptions for “young and elderly,” noting that the drug was being used “not just by those attempting to fit into their bikinis,” but also by people who needed to shed weight for health reasons.
Earlier this year, a diabetic who couldn’t get her monthly Ozempic script for six weeks stated she had dangerously high blood sugar and bacterial infections throughout that period.
While the Royal Australian College of GPs advises clinicians to “exercise caution” when prescribing off-label medications, vice president Dr. Bruce Willett of the RACGP says it “does need to be done from time to time.”
“Sometimes a pharmaceutical will have strong data to support its usage, but the business may not have the commercial motivation in getting it registered for that use,” he added, saying that off-label prescribing was often utilized to supply older style antidepressants to chronic pain patients.
“When it comes to weight loss medicines, it’s vital to realize that they’re never a one-size-fits-all solution.”
People with obesity, according to Associate Professor Samantha Hocking, an endocrinologist and obesity specialist at the University of Sydney’s Charles Perkins Centre, need improved access to weight-loss medicines.
“When people lose weight, there’s a physiological response to prevent your body from losing weight, and your appetite hormones shift,” she explained. “Pharmacotherapy is crucial for long-term weight loss.”
Hocking believes that the lower cost of Ozempic compared to the rival weight-loss medicine Saxenda, which is not listed on the PBS, is why GPs are prescribing it.
“It’s not like individuals are buying it from TikTok or from a black market pharmacy — someone is deciding that this person needs the prescription to lose weight and is willing to administer it off-label,” she explained.
“Part of it is due of the social media fame, but there are undoubtedly a lot of other people who are being prescribed this drug because they are having trouble losing weight.”
A spokesperson for the Pharmaceutical Society of Australia said it had “anecdotally” heard stock was slowly returning to more manageable levels, but advised people with type 2 diabetes who are having trouble getting their medication to take their prescription to a single pharmacy as soon as possible, as they were working their way through waiting lists.
“Calls to various pharmacies with stock inquiries are unlikely to be successful and can put strain on the supply chain,” they stated.