Dr Ian Neeland Describes Patient Experience During Semaglutide Shortage

Ian Neeland, MD, serves as director of cardiovascular prevention and co-director of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease at the University Hospitals Harrington Heart & Vascular Institute, as well as associate professor of medicine at Case Western Reserve University School of Medicine. Here, he talks about challenges patients with diabetes are facing amid the semaglutide shortage, which requires individualized adjustments such as dose reduction, alternative medication sources, or seeking options abroad to maintain glycemic control and minimize disruptions in therapy.

Transcript

What happens to patients with diabetes when their semaglutide regimen gets thrown off schedule, and how do you combat this amid the ongoing shortage?

I would say it's not one size fits all with regard to the patients with diabetes who are using these medications for weight loss. It kind of depends on what their regimen is, overall, what their glycemic control is at the time, and then how long we think the shortage might be lasting.

For example, if a patient is on a certain dose of semaglutide and that dose is in shortage, often what I'll do is either reduce the dose to the next available dose or incorporate other options for patients using our pharmacists, trying to find the medication at alternative pharmacies. Sometimes people even get it from out of the country—in Canada, for example. I think there are different ways you can modify what they're taking [or] the dose they're taking to try to help them bridge the gap due to the shortages. And the shortages, also, are very variable. Sometimes a certain dose of a certain medication will be on shortage, and then they'll get plenty of that, and then a different dose of a different medication will go on shortage.

What I try not to do is try to interrupt or disrupt therapy with no therapy for long periods of time because these medications, as you know, have to be dose escalated over time, and a break in therapy for longer than a couple of weeks usually would necessitate going back down to the original dose and then going back up over time to the target dose. And that takes time. It may reduce the efficacy of their glycemic control during that time period, so I try not to have as much of a break therapy as I can. But I try to help them bridge that gap by finding either the drug somewhere else or a small dose reduction to the next lower available dose with the aim to get back to the original dose as soon as possible.