What’s the Latest with the GLP-1 Shortage?

In response to a nationwide shortage of GLP -1 RAs, a National Patient Safety Alert was recently broadcasted to provide further background, clinical information, and actions for providers. This shortage is expected to last until at least mid-2024. The following article provides a summary of the alert and the actions you can take within your clinical teams to tackle the shortage safely:

1. Do not prescribe for obesity

The off-label use of these agents for the management of obesity is strongly discouraged. The supply issues have been caused by an increase in demand for these products for licensed and off-label indications. Existing stock must be conserved for use in patients with diabetes.

2. Avoid new initiations

Do not initiate new patients on GLP-1 RAs for the duration of the shortage.

3. Do not switch between brands of GLP-1 RAs, including between injectable and oral forms

4. Do not double up a lower dose preparation where a higher dose preparation of GLP-1 RA is not available.

5. Do not prescribe excessive quantities

Limit prescribing to minimize risk to the supply chain while acknowledging the needs of the patient.

6. Consider switching to insulin & other therapies

Some patients established on GLP-1 RA therapy for type 2 diabetes may need to be switched to alternative treatments including insulin. This should be done by an experienced & competent clinician. Also ensure that the choice of insulin is as per information on the SPS page on prescribing available insulins as not all suppliers are able to manage an uplift in demand.

7. Consider stopping treatment

Review the need for prescribing a GLP-1 RA agent and stop treatment if no longer required due to not achieving desired clinical effects as per NICE NG28. This is defined by NICE as a reduction of at least 11 mmol/mol [1.0%] in HbA1c, and weight loss of at least 3% of initial body weight in 6 months.

8. Refer patients to structured education & weight management programmes

Support patients to access structured education and weight management programmes where available.

For further clinical guidance on how to manage your patients that are affected by the shortage, you can refer to this tailored guidance produced by the Primary Care Diabetes Society (PCDS) and Association of British Clinical Diabetologists (ABCD): Guidance Document

If you would also like to view the original alert, please click here.