Influencers bypassing ad code to spruik diabetes drug for weight loss

TikTok influencers are spruiking Ozempic.Credit: Instagram

Social media influencers are “bypassing” strict advertising codes with viral videos promoting the use of a vital prescription drug as a weight-loss treatment, causing shortages for people with diabetes.

Pharmacy Guild of Australia NSW president David Heffernan said it was frustrating when videos glamorising prescription-only drugs on social media lead to panic buying.

“It’s illegal to advertise Schedule 4 medicine. It’s meant to be kept out of public view,” he said.

“Social media is an opportunity to bypass this [advertising code] and I get frustrated when I see panic buying that comes up because that’s when we see medicine shortages as we saw in the pandemic”.

A recent trend has seen TikTok and Instagram users document their weight loss journey after taking the diabetes drug Ozempic, garnering more than 76 million views.

The drug, a weekly injection used to manage blood sugar levels in people with type 2 diabetes, has been available in Australia since 2019. It increases insulin secretion, resulting in increased sugar metabolism.

Last month, a coalition of medical groups, including Diabetes Australia, the Australian Medical Association and the peak bodies for pharmacists and GPs, along with Ozempic’s manufacturer Novo Nordisk, released a joint statement with the Therapeutic Goods Administration. They advised health professionals to limit prescribing and dispensing Ozempic to people with insufficiently controlled type 2 diabetes.

The statement discourages GPs from prescribing Ozempic “off-label”, which refers to when doctors write a script for a drug for a purpose for which it is not registered.

“Everyone [is] saying at the coffee shops saying ‘geez you’ve got to get onto this drug, I dropped five kilos in two weeks’.”

David Heffernan, Pharmacy Guild of Australia NSW president

Data from the federal Department of Health shows the number of scripts issued monthly for the drug nationally increased six-fold over 2021 to more than 86,000 in December, in what is considered a response to its approval as an obesity treatment abroad.

Ozempic is a Schedule 4 drug, which is a prescribed and restricted substance that cannot be advertised to the public as per the TGA code guidelines.

The code exists to ensure advertising of drugs is socially responsible, only promotes quality use and does not mislead or deceive – but has a broad definition of advertising. The TGA’s guidelines specifically refer to when influencers in commercial relationships are promoting the drug because of a commercial relationship.

Heffernan said social media posts from unpaid influencers could lead to diabetic patients missing out on getting their drugs.

“With social media, increasing the popularity of the drug ... everyone [is] saying at the coffee shops saying, ‘Jeez, you’ve got to get onto this drug, I dropped five kilos in two weeks.’ ”

Bondi Pharmacy’s pharmacist Pam Sack said she initially saw an increase in people purchasing the drug in December. Between February and April, the number of scripts filled each day “doubled and tripled”.

She is now out of stock. “It’s taken off so much in terms of off-label prescribing; they didn’t plan for the huge demand.”

She said she had filled Ozempic scripts for people “young and old”, noting it was “not just people trying to fit into their bikinis” but also people using the drug to lose weight for health reasons.

One diabetic unable to access her usual Ozempic script for six weeks earlier this year said she had experienced dangerously high blood sugar and bacterial infections during that time.

While the Royal Australian College of GPs generally encourages doctors to “exercise caution” with off-label prescribing, it “does need to be done from time to time”, RACGP vice president Dr Bruce Willett said.

“Sometimes a medication will have good research to support its use, but the company may not have the commercial interest in having it registered for that use,” he said, noting off-label prescribing was commonly used to provide older style anti-depressants to patients experiencing chronic pain.

“The important thing to remember with all weight loss medications is they are never a standalone solution.”

Associate Professor Samantha Hocking, an endocrinologist and obesity specialist at the University of Sydney’s Charles Perkins Centre, said people with obesity needed better access to drugs that assisted weight loss.

“When people lose weight, there’s a physiological response to stop your body losing weight, your hormones that control appetite change,” she said. “Pharmacotherapy to sustain weight loss is critical.”

Hocking said she believed the lower price of Ozempic compared with alternative weight-loss drug Saxenda, which is not listed on the PBS, was probably why GPs were choosing to prescribe it.

“It’s not like people are getting it from TikTok or a black market pharmacy – someone is making a decision that this person needs the medicine to lose weight and is prepared to prescribe off-label,” she said.

“The social media popularity is part of it, but there are probably a lot of other people who are being prescribed this medication because they have struggled to lose weight.”

A Pharmaceutical Society of Australia spokesperson said it had “anecdotally” heard stock was slowly returning to more manageable levels, but advised people with type 2 diabetes who are struggling to access their medication to take their prescription early to a single pharmacy, as they were working through waiting lists.

“Phoning multiple pharmacies with stock queries is unlikely to be successful and can put pressure on the supply chain,” they said.

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