To curb the semaglutide black market, the UK must build safe, secure supply chains

In today's guest article, Alistair Murray , Chief Pharmacist at?Phlo Connect?raises a critical question. In a world with increasing drug accessibility and lagging regulatory measures, how can healthtech companies, pharmacies, and clinicians ensure safe access to semaglutide for only those patients with a clinical need?

Speaking at the annual J.P. Morgan Healthcare conference just a few weeks ago, Novo Nordisk CEO, Lars Fruergaard J?rgensen,?announced?that the pharmaceutical giant is “just getting going” with efforts to expand sales of their flagship drug, semaglutide. His confidence mirrors?predictions?from all corners of the pharmaceutical and healthcare world: that the popularity of weight loss medications will continue to grow exponentially throughout 2024 and the rest of the decade. In line with these predictions,?J.P Morgan data?shows that the burgeoning industry may produce as much as $100 billion in revenue annually by 2030.?

But the question hanging over these sizable projections is one that cannot be ignored. In a world where people have more avenues along which to access drugs than ever before, and where governmental & industry regulation often struggles to keep pace with innovation, how can healthtech companies, pharmacies and clinicians ensure that patients with clinical need (and only these patients) are provided with safe access to semaglutide medications??

Global health breakthrough or cause for concern?

Semaglutide, which belongs to a class of drugs known as GLP-1 receptor agonists, has the potential to?improve global health outcomes on an unprecedented scale. Its mechanism of action involves enhancing the release of insulin, suppressing glucagon, and slowing gastric emptying, which together help control blood sugar levels and promote weight loss. This makes it a highly effective treatment for type 2 diabetes and obesity (when coupled with multidisciplinary support and health education) conditions which are amongst the biggest global killers and which cost economies?many trillions of dollars?annually.?

First approved by the U.S. Food and Drug Administration (FDA) in 2017 under the brand name Ozempic, in 2021 the FDA approved a higher-dose formulation of Semaglutide (branded Wegovy) specifically for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol).

From this point onward, the public appetite for access to the appetite-suppressing drug has been insatiable. Celebrities and influencers - including Elon Musk and Oprah - have taken to social media to attribute their weight loss successes to Wegovy and Ozempic, which helped trigger a surge in demand both from people struggling with long term weight management and those after quick-fix solutions.?

However, issues in the semaglutide production and supply chain, coupled with a rise in off-label prescriptions and several other confounding factors, led to a shortage of semaglutide for patients in the UK in 2023. As revealed following a?BBC investigation, this shortage meant that some patients who needed the drug for diabetes management were not able to access it, and others turned to unregulated, unlicensed providers and the black market to get their hands on a supply. This highly risky, and oftentimes expensive, avenue to semaglutide is one which must be eliminated as a matter of urgent public safety.

Designing a safe and secure infrastructure??

To combat this effectively, we need to see commitment and collaboration from across the healthtech community, pharmacies, government, regulators and manufacturers. This should include a recognition of their joint responsibility to educate the public about the dangers of purchasing medical products via social media and other unofficial channels – and to crack down harder and faster on illegal vendors. Together, these bodies can encourage the improvement and further adoption of regulated supply chains for semaglutide that use new verification and tracing technologies. This would help ensure that safe, approved versions of the drug are provided to patients who meet the strict eligibility criteria at a set price point.?

To ensure safety, every supplier must adopt systems built to be fully transparent, and in line with the highest security standards, to reduce the risk of hacking, patient data leaks or unauthorised access. As an additional consideration, expanding access to the Summary Care Record API to prescribing clinicians would provide a mechanism for more comprehensive screening of patients' pre-existing conditions. This would help avoid inappropriate prescribing and improve the screening process of patients' pre-existing conditions.?

It’s encouraging to see that progress is underway towards constructing these systems - in fact, many of the online pharmacy providers who have begun prescribing Ozempic and Wegovy have already implemented robust and secure infrastructure to guarantee patient safety. However, without universal commitment from every player in the ecosystem, there will always be cracks through which harm to patients may occur. There’s no time to waste in pursuing universal adoption of a national, properly regulated and policed supply chain so that the global health benefits of semaglutide can be realised in full.??

Alistair Murray is Chief Pharmacist at?Phlo Connect. An experienced prescribing pharmacist and a digital pharmacy compliance expert (he was founding clinician at online pharmacy Echo, which was acquired by LloydsPharmacy in 2019) Alistair has extensive experience in the intricacies of medication supply chain management, as well as an insider’s understanding of the distribution of regulated drugs - including Ozempic and Wegovy.?