Semaglutide, the diabetes and weight-loss drug marketed under the names Ozempic, Wegovy, and Rybelsus, has gotten a lot of attention recently due to shortages arising from increased demand. Ozempic and Wegovy are both manufactured by the Danish pharmaceutical company Novo Nordisk, but only Wegovy has regulatory approval for the treatment of obesity.
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist with a molecular weight of about 4.1 kDa and 94% similarity to naturally occurring GLP-1. The difference from GLP-1 lies in two amino acid substitutions, one of which prevents the peptide from being broken down in the body by dipeptidyl peptidase-4 and gives the drug its unusually long biological half-life of about a week . By mimicking GLP-1, semaglutide increases the production of insulin, and may also promote the growth of beta cells in the pancreas, which are responsible for insulin production.
Recently, insurance companies have been cracking down on the off-label prescription of Ozempic for weight loss after an investigation by Anthem Blue Cross Blue Shield found that more than 60 percent of patients being prescribed Ozempic lacked sufficient evidence of diabetes. The insurer also cited the fact that shortages due to off-label prescribing have made it difficult for diabetic patients to access the drug.