#pharmabusiness

Ozempic, Wegovy, Trulicity, and similar compounds mimic the GLP-1 hormone. They signal the pancreas to release more insulin upon high blood sugar and protect the heart and kidneys. They were created primarily for Type 2 Diabetes (insulin resistance) control. They also suppress appetite, hence their application for weight loss.

In 2024, as I think most people know, GLP-1s experienced a massive shortage. People with Type 2 Diabetes and people who needed to lose weight (for MEDICAL PURPOSES) could not get the TREATMENT they needed because so many were using these drugs off label. That deficit is marked as resolved.

So why am I mentioning this?

See, the shortage wasn’t just the GLP-1s themselves, it was their delivery mechanisms: plastic pens, single-use ones. You know what other shortage has been going on? Insulin. Eli Lilly and Novo Nordisk still experience low supply for several products. Some vials, some penfills, but the group also includes Fiasp FlexTouch prefilled pens (which I currently use) and Levemir Flexpens, both single-use.

Novo Nordisk manufactures Ozempic and Wegovy, and Eli Lilly makes Mounjaro. Hm.

Now, I’m not an expert on this. I could be missing a big piece, and I don’t want to spread misinformation. Do your own supplemental research, come to your own conclusions.

But these companies are loud about the fact that they do not care. It’s not as profitable for them anymore. Novo Nordisk has stopped focusing on cell therapy and diabetes cures. They’ve announced that they’ll be discontinuing several kinds of insulin from 2024 - 2026. Both them and Eli Lilly are actively pivoting towards this more ‘marketable’ and monetarily satisfying venture.

In addition, the GLP-1 struggle isn’t really over either. The FDA’s proclamation partially halted compounded formulas, but demand remains high, and so do prices. PEOPLE WHO NEED THEM STILL STRUGGLE TO GET THEM, AND NOW, ALSO STRUGGLE TO PROVE THAT THEY DO.

I hesitate to stray to the anecdotal, but this isn’t merely data for me. It’s my life. I have experienced insulin pen shortages through Novo Nordisk. I have had to ration my LIFE-SAVING MEDICATION. I know many, many people who have had to do the same. And it worsened at the same time as GLP-1 usage exploded.

لسة ألف طريق وسكة

Also it was one of those expanded stores, (they call it "y más" here, idk how widespread that is) so I think it offered more services. I know it had an expanded inventory; I once bought a nose piece for my cpap there, which the independent medical supply store I tried wanted to see a prescription for.

(Not saying that store was wrong for that, I'm sure it makes sense within the context of how they operate, but, like...i don't have a prescription, and you can definitely buy all those parts without one online.)

I don't actually know really anything about how pharmacies operate, but I have been taking prescription medications continuously for my entire life, and I can't help but feel like there's been a pretty big decline in quality of service over the last few decades.

For the last, maybe 15 years? The number of 24 hour pharmacies has been continuously decreasing, making it harder for people who work, or just, like, have shit going on, to pick up their medications when it's convenient for them. (And my city definitely doesn't have a shortage of people who work, or have other shit going on! Or have medical issues! I don't know the actual numbers, but I know my city's population has been growing my whole life; we have one of the lower costs of living among the major cities in the US, so people are always moving here from more expensive places.)

And, at least since I've become an adult, I've rarely visited a pharmacy counter that doesn't seem understaffed. Like, it's just a given that you're going to have to wait like 20 minutes to get your prescription. And I usually walk inside, so I can see the poor pharmacists and techs running around and rushing, trying to get everything done at once. (And I get that there are rush hours, but that's something you can plan for and staff accordingly!!)

I really don't think there's, like, a shortage of people trying to become pharmacy techs? And the only other explanation I can think of is the capitalist mindset of, "the company is going to make its money either way, so why should it care about the customer experience, or if its employees are overburdened?" Which seems unfortunately likely.

And there's the thing where you have to call a robot to talk to a pharmacist, and you can't get through until you listen to the robot tell you that she REALLY THINKS she can help you with what you need, instead. And then, sometimes you get through to a person, and they're a call center employee who, like. Doesn't know anything about pharmaceuticals. (Usually everyone I talk to IS trying their best to be helpful. It's just a process.)

I think this is not as much of an issue currently, but remember when there was a shortage of adhd meds? You know, that me and lots of other people need to function every day? The advice that I, and others I know irl, got, when we were told our usual pharmacies wouldn't have our meds in the foreseeable future, was to call individual pharmacy locations, ask them if they happened to have the pill we need in stock, and then contact our doctor once we found a place that did, and have them send our script to that location. And then hope they still had it in stock by the end of that process.

(EDIT TO ADD: if you need to do this, try calling different company stores, like, one Walgreens, one CVS, etc. Bc the Walgreens are likely all supplied by the same supplier, so if the supplier is out, they're all out. Idk if this is obvious to everyone else or not, but when I first did it, I wasted time calling like 5 different Walgreens 😅 This is why I still currently get my Adderall from a different pharmacy than the rest of my meds.)

The whole thing made me wonder if there was any kind of legal "continuity of care" concept for pharmacies, and I don't think there is! Continuity of Care is a federal requirement that your doctor keep seeing you if you still need to be seen. They don't HAVE to see every patient who asks to be seen, but once they start seeing you, they can only break the patient-provider relationship under very specific circumstances, and often they're supposed to direct you to an alternate provider if they do.