The NHS had been facing supply issues with glucagon-like peptide receptor agonists (GLP-1 RAs, or GLP-1 analogues), a range of drugs used for managing blood glucose levels in people with type 2 diabetes.
The global shortage in supply was partly due to a surge in off-label prescriptions of the drug semaglutide being issued for weight loss, which was exceeding supply.
Previously (since the summer of 2023) all stocks of GLP-1 RAs had to be reserved for those already using these medications, meaning that thousands of people who could benefit from these medications were not able to access them.
In the second half of 2024, we were pleased to see an increase in supply of Rybelsus, which meant that people could be newly initiated on a GLP-1 medication. And another drug called Mounjaro has since become available as a treatment for people with type 2 diabetes across the UK.
At the end of January this year it has been reported that the shortages of GLP-1 medications have now been resolved.
What's the latest with the shortage of GLP-1 RAs?
It has now been reported that previous shortages of the GLP-1 agonists Ozempic (injectable semaglutide), liraglutide, dulaglutide and exenetide have now been resolved. There is also a good supply of Rybelsus (oral semaglutide) and Mounjaro (tirzepatide).
In June 2024, the World Health Organisation (WHO) issued a warning over fake versions of semaglutide which have been identified in the UK. The WHO has advised that semaglutide treatment should only come through a healthcare professional.
What is the latest guidance?
Guidance in a National Patient Safety Alert in January 2024 and a Medicines Safety Notice in March 2024 outlined a set of actions for clinicians to follow until the shortages were resolved.
There is no specific guidance now the shortages have been resolved, but it is still recommended that GLP-1 RAs are only prescribed for their licensed indication.
It is also recommended that clinicians:
- Discuss stopping the GLP-1 RA if treatment goals have not been achieved.
- Avoid doubling up a lower dose preparation where a higher dose preparation of a GLP-1 RA is not available.
- Do not switch between strengths of a GLP-1 RA solely based on availability.
- Do not prescribe more than one month’s supply unless there is clear reason to do so.
What did Diabetes UK do?
We supported the guidance, and had ongoing discussions with manufacturers and the Department for Health and Social Care about our concerns over how this was impacting people with diabetes, and how the situation might be improved.
Douglas Twenefour, Head of Care at Diabetes UK, said:
“We fully support the instruction that GLP-1 medications should not be prescribed off-label under any circumstances while there is any shortage impacting people with type 2 diabetes.
"We welcome the increased supply of Rybelsus and the introduction of Mounjaro – which offers the chance for people with type 2 diabetes who meet the criteria to be started on a GLP-1 medication.
"If anyone remains affected by any shortages you should contact your healthcare team.”
What to do if this affects your prescription
We advise that you contact your healthcare team if you’re still unable to get supplies of your prescribed GLP-1 analogues. If your medication changed and you need still need support, ask your healthcare team about structured education and whether a referral to diabetes remission or weight management programme might be suitable for you.
