National patient safety alert on shortage of GLP-1 receptor agonists released by DHSC

By Editor
21st July 2023
Department of Health, Pharmaceutical Pharmacy Type 2 diabetes

GPs have been urged to stop prescribing glucagon-like peptide-1 (GLP-1) receptor agonists to individuals simply looking to lose weight.

The Department for Health and Social Care (DHSC) has issued a national patient safety alert on the shortage of GLP-1 receptor agonists to tell doctors to only prescribe semaglutide to people living with diabetes.

Otherwise known as Ozempic, the NHS prescribes the drug for managing blood glucose levels in individuals with type 2 diabetes.

However, semaglutide is now being used to help people lose weight, including some top celebrities, such as Kim Kardashian and Elon Musk.

Last month, the DHSC announced that there are very limited, intermittent supplies of all GLP-1 receptor agonists.

The shortage has been caused by an increase in demand for these products for licensed and off-label indications, with the supply not expected to return to normal until at least mid-2024.

During the shortage, clinicians are also required to:

  • Only prescribe GLP-1 RAs for their licensed indication
  • Review the need for prescribing a GLP-1 RA agent and stop treatment if no longer required due to not achieving desired clinical effect as per NICE CG28
  • Avoid switching between brands of GLP-1 RAs, including between injectable and oral forms
  • Where a higher dose preparation of GLP-1 RA is not available, do not substitute by doubling up a lower dose preparation
  • Where GLP-1 RA therapy is not available, proactively identify patients established on the affected preparation and consider prioritising for review based on the criteria below.
  • Where an alternative glucose lowering therapy needs to be considered, use the principles of shared decision making as per NICE guidelines
  • Where there is reduced access to GLP-1 RAs, support people with type 2 diabetes to access to structured education and weight management programmes where available
  • Order stocks sensibly in line with demand during this time, limiting prescribing to minimise risk to the supply chain whilst acknowledging the needs of the patient.

Clinicians should consider prioritising review for people with type 2 diabetes on the affected GLP-1 RA preparation where:

  • HbA1c greater than 86mmol/mol in the previous 3 to 6 months
  • HbA1c greater than 86mmol/mol prior to starting the GLP1-RA
  • HbA1c not recorded in the previous 6 months
  • Urine albumin creatinine ratio (uACR) greater than 30mg/mmol
  • Self-monitoring glucose readings (or Continuous Glucose Monitoring, where available) are persistently above individualised target range.

To access the latest National Safety Alert on the shortage of GLP-1 receptor agonists, click here.

For more information, click here.

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