How do I obtain Ozempic (semaglutide)?

How to Obtain Ozempic (Semaglutide)

Ozempic (semaglutide injection) requires a prescription from a licensed healthcare provider and is FDA-approved specifically for type 2 diabetes, not for weight loss alone. 1

Prescription Requirements

You must have a valid medical indication to obtain Ozempic:

• Type 2 diabetes with inadequate glycemic control - This is the FDA-approved indication for Ozempic 1, 2, 3
• Most appropriately prescribed when HbA1c remains ≥7.5% (58 mmol/mol) despite other antidiabetic therapy including metformin 2
• Can be used as monotherapy or in combination with other glucose-lowering medications 1

Clinical Scenarios Where Ozempic Is Prescribed

For patients with type 2 diabetes, Ozempic is prioritized when: 1

• Established cardiovascular disease - Semaglutide has demonstrated cardiovascular benefit, reducing major adverse cardiovascular events 1
• Need for significant weight loss - GLP-1 receptor agonists like semaglutide provide intermediate to very high weight loss efficacy 1
• High cardiovascular risk - Even without established disease, indicators of high ASCVD risk support use 1
• Chronic kidney disease - Semaglutide shows benefit for renal endpoints driven by albuminuria outcomes 1

Important Prescribing Limitations

Off-label prescribing for weight loss without diabetes is common but creates supply issues: 1, 4

• Ozempic is not FDA-approved for weight loss in people without type 2 diabetes 1
• Insurance coverage is typically restricted to the FDA-approved diabetes indication 1
• In Denmark, one-third of new users in 2022 did not have type 2 diabetes, contributing to global supply shortages 4
• For weight loss without diabetes, Wegovy (semaglutide 2.4 mg) is the FDA-approved formulation, not Ozempic 1

Steps to Obtain Ozempic

1. Consult with an appropriate healthcare provider: 1

• Primary care physician, endocrinologist, or diabetologist
• Must document type 2 diabetes diagnosis
• Should assess HbA1c level and current medication regimen

2. Meet clinical criteria: 1, 2

• Confirmed type 2 diabetes diagnosis
• Suboptimal glucose control (typically HbA1c ≥7.5% or 58 mmol/mol) 2
• Failed or inadequate response to other antidiabetic medications, particularly metformin 2

3. Insurance considerations: 1

• Medicare currently excludes coverage of medications for obesity alone 1
• Private insurance typically requires documented diabetes diagnosis
• Prior authorization often required demonstrating inadequate response to metformin

4. Prescription and administration: 2, 3

• Prescribed as pre-filled pen for subcutaneous injection 2, 3
• Administered once weekly 1, 2
• Available in 0.5 mg or 1.0 mg doses 1, 2

Critical Caveats

Supply shortage considerations: 4

• Global shortages exist, particularly for GLP-1 receptor agonists 1
• Off-label use for weight loss has contributed significantly to supply constraints 4
• Prioritization should favor patients with type 2 diabetes and clear medical indications 4

Pre-operative concerns: 1

• Semaglutide delays gastric emptying and increases aspiration risk during anesthesia 1
• Should be discontinued 10-14 days before elective procedures requiring anesthesia 1
• Increased residual gastric content noted even with extended fasting times 1

Contraindications and monitoring: 1

• Thyroid C-cell tumors identified in rodents; human relevance not determined 1
• Avoid in patients at high risk for pancreatitis 1
• Monitor for gallbladder disease 1
• Close monitoring of diabetic retinopathy in high-risk patients (≥10 years diabetes duration) 1