High price and demand for semaglutide means lack of access for US patients

So many celebrities have admitted to taking Ozempic—a brand of the diabetes and obesity drug semaglutide—that comedian Jimmy Kimmel made a joke about it at the Academy Awards ceremony on 12 March 2023.1 Dubbed a “miracle weight loss drug” of the rich, the high demand and high prices for semaglutide have led to shortages and desperate measures to get the drug in many countries, including the United States.

A Canadian doctor living in the US was recently caught writing tens of thousands of prescriptions for semaglutide for US residents, filled by two online pharmacies in British Columbia, Canada.2 Counterfeit Ozempic has found its way into a US pharmacy,3 and spas and online pharmacies are passing off placebos or potentially harmful substances as semaglutide. At the same time, “almost every patient who comes through the door could benefit from these drugs [for diabetes or obesity], but they can’t afford them,” says Harlan Krumholz, who helps at a general medical clinic for people without insurance.

A study co-authored by Krumholz, a cardiologist with Yale New Haven Hospital in Connecticut, shows that half of US adults would be eligible for semaglutide for obesity or overweight status, according to the US Food and Drug Administration’s (FDA’s) criteria (box 1).4 And the proportions are higher for black (56.6%) and Hispanic adults (55.0%), which Krumholz thinks is because of “a long and unfortunate history of structural racism” in the US. But many people who could benefit from semaglutide and similar drugs have no drug insurance …