Introduction
If you’ve ever struggled with type 2 diabetes or obesity, then you might have already looked up what’s probably the hottest drug right now, Ozempic. Ozempic, with the active ingredient semaglutide, not just regulates blood sugar levels, but can also help you lose up to 15% of your weight.
Even the biggest Hollywood personalities like comedians Chelsea Handler and Tracy Morgan as well as SpaceX/Tesla’s Elon Musk have gone on the drug. Because of its massive popularity, semaglutide has been running out of stock worldwide.
You might ask yourself, ‘How do you get semaglutide?’ ‘Who can prescribe semaglutide?’ In this guide, we cover the FDA’s guidelines on healthcare professionals with the authority to prescribe it.
What is semaglutide?
It’s no surprise that semaglutide is flying off the shelves, what with its efficacy. But what exactly is it and how does it work? How is it able to regulate blood glucose and promote weight loss? The secret lies in its composition.
In our gut is a hormone, glucagon-like peptide-1, or GLP-1 for short. Whenever we finish eating and our blood sugar levels spike, GLP-1 triggers the release of insulin to reduce blood sugar levels.
Semaglutide, on the other hand, is a glucagon-like peptide-1 receptor agonist, or GLP-1 Ra. It mimics GLP-1 in response to high blood sugar levels, prompting the pancreas to secrete the right amount of insulin.
At the same time, semaglutide also delays gastric emptying, where food exits the gut and enters the small intestine. Because digestion is slower, people feel fuller for longer, so they have fewer food cravings. Correspondingly, lower caloric intake typically results in significant weight loss. Semaglutide also sends signals to the brain that you’re already full.
Eligibility
To be eligible to take semaglutide, you first have to meet certain diagnostic criteria. Consumers also need a prescription to avail of the drug.
For an Ozempic or its sister brand Rybelsus prescription, you must have type 2 diabetes, which they have FDA approval for. Doctors may also prescribe Ozempic for heart disease. This is because it has additional approval for lowering the risk of cardiovascular problems. It is also applicable to those dealing with insulin resistance.
Meanwhile, Wegovy targets obesity. Patients need a BMI of 27+ with a weight-related condition or a BMI of 30+. Doctors often prescribe Ozempic off-label for weight loss.
Although Ozempic, Wegovy, and Rybelsus are marketed differently, they all regulate blood sugar and manage weight. This is why many doctors choose to prescribe Ozempic or Rybelsus off-label for weight loss.
Oral and subcutaneous semaglutide
Semaglutide comes in two formats: oral and subcutaneous semaglutide. People call Rybelsus oral semaglutide as it comes in tablet format and they take it orally. Meanwhile, people refer to Ozempic and Wegovy as subcutaneous semaglutide. They come in injectable dosing pens and you inject them under the skin. For Rybelsus, on the other hand, you must take it orally once daily on an empty stomach.
If you are uncomfortable about having to inject yourself with a medicine, Rybelsus might be more suitable for you. However, if you prefer less frequent administrations, then Ozempic or Wegovy may be better for you.
Dosage and administration
If you’re new to semaglutide, your doctor will typically start you off on a low dose. He or she’ll gradually increase this until you reach a maintenance dose. This is to help your body adjust to the drug.
Both Ozempic and Wegovy can be injected subcutaneously in three different injection sites: your abdomen, thigh, or upper arm. You must take it once weekly regardless of meals.
Make sure that you are not injecting into a muscle or vein. It is best to use a different injection site with every injection. However, if you want to use the same injection site, pick a different spot in that area.
Cost of semaglutide
There are several ways you can get a prescription for semaglutide—from a doctor or online from a state-licensed pharmacy. You can also get it from an FDA-registered outsourcing facility or a telemedicine company.
According to a November 2024 report, semaglutide brands had the following pharmacy retail prices for one months’ supply:
- Ozempic: $830-870 (list price at $968.52)*
- Wegovy: $1,237-$1,340 (list price at $1,349.02)*
- Rybelsus: $848-$917 (list price at $968.52)*
With insurance
With insurance, Ozempic can cost $25 for one to three months’ supply, while Wegovy can cost $0 per dose with insurance. Patients can also use Wegovy’s savings card, where people with insurance can save up to $225 for every 28-day supply. Those without insurance, meanwhile, can save up to $500, also for a 28-day supply.
Rybelsus’ cost, on the other hand, will vary depending on the insurance plan, treatment plan, and the pharmacy. Patients with insurance eligible for savings and support may pay as low as $10 for one to three months’ supply.
If you have insurance, you might need to secure prior authorization first before your provider covers Rybelsus.
*Prices subject to change
Who can prescribe semaglutide?
To get a semaglutide prescription, schedule an appointment with a healthcare professional like a primary care physician or an endocrinologist. He or she will assess your medical history and your weight loss goals to determine if you’re a good candidate. This usually involves examining your blood work drawn within the last three to six months. Your doctors need to make sure you don’t have thyroid problems, pancreatitis, or underlying diabetes.
If eligible for semaglutide, your doctor will then identify the best semaglutide for you. He/she will then send your prescription to a physical or online pharmacy.
According to Veronica R. Johnson, M.D., an internal medicine physician specializing in obesity medicine, many PCPs have expertise in prescribing medicine for treating those who are overweight or obese.
In such cases, a referral to another healthcare provider may be necessary, Johnson told Forbes.com.
Seth M. Kipnis, M.D., medical director of bariatric and robotic surgery, added that obesity has many causes and patients’ treatment plans must specifically meet their requirements. A dietitian and a psychologist provide strong support for weight management treatments.
A 2023 report by Medscape notes that in 2022, prescriptions for semaglutide rose by 150%. Additionally, the number of prescriptions healthcare providers wrote rose by 80%.
General and family practice providers accounted for 30% of these healthcare professionals, with internists following at 15%. Meanwhile, endocrinologists followed at 4%, OB-Gyns at 2%, and pediatricians at 1%. Cardiologists, surgeons, and emergency medicine physicians comprised the rest.
Only get a prescription from regulated sources like licensed healthcare professionals, state-licensed pharmacies, or FDA-registered outsourcing facilities. This is so that you can avoid falling prey to illegally procured or unsafe medicine.
Looking for a reputable online pharmacy? Check out this link from the FDA website to locate a state-licensed online pharmacy.
Psychiatrists can prescribe semaglutide
Yes, psychiatrists can prescribe semaglutide. An August 2023 report stated more U.S. psychiatrists prescribed Wegovy to patients who gained weight from mental disorder medicines.
Weight gain is a common potential side effect of several mood stabilizers and antipsychotic drugs. This can also increase the risk of heart disease and diabetes.
“When you’re on the psychiatric meds, you’re so hungry, you just eat whatever is available,” described Alexander Roger, who has been diagnosed with bipolar disorder.
Other ways to obtain semaglutide
Apart from getting a prescription from a healthcare provider, you can also get a prescription online from telehealth companies. Just remember that you might need to still undergo lab tests first. To stay on the safe side, make sure you’re sourcing from a telemedicine company that employs board-certified doctors.
When choosing a telemedicine company, consider your health insurance coverage and the cost of buying semaglutide through them.
Following lab tests and the screening process, most telemedicine companies will send the prescription to a local pharmacy. From there, you can pick up your supply of semaglutide.
The supply problem
As mentioned, the massive popularity of semaglutide led to a major supply issue. The shortage problem will likely persist for several more years. Wall Street, however, predicts the demand for the drugs will slow down in 2024 with more treatments becoming available in the market.
As of January 2024, pharmaceutical companies have been increasing the prices of their medications, including Ozempic.
As consumers grapple with the problem, healthcare providers have been turning to alternatives to treat type 2 diabetes and obesity. These include Trulicity (dulaglutide), Victoza (liraglutide), Bydureon (exenatide), Rybelsus (semaglutide), Adlyxin (lixisenatide), and Byetta (exenatide).
Over 650 million people are suffering from obesity worldwide, and around 480 million, meanwhile, have type 2 diabetes.
The problem with compounded semaglutide
Apart from other GLP-1 drugs, consumers are turning to compounded semaglutide. It’s a version of the drug which contains other ingredients such as vitamins.
While the FDA has approved some drugstores to custom-mix variations of semaglutide, reports have cited that these have adverse effects. Novo Nordisk and its rival drugmaker Eli Lilly have also reported impurities in the compounded medications.
Other reports have noted that compounders used salt forms of semaglutide, semaglutide sodium and semaglutide acetate.
Although compounded semaglutide is a cheaper alternative, people must get it from an outsourcing facility or a state-licensed pharmacy. If you are buying semaglutide online, make sure you are purchasing from a valid and reputable online pharmacy.
Conclusion
You can get a semaglutide prescription from healthcare professionals or clinicians like primary care physicians or endocrinologists. You can also get a prescription from a telemedicine company.
Psychiatrists may also prescribe semaglutide for weight management as weight gain is a common side effect of psychiatric meds.
The FDA reminds consumers to only get semaglutide from licensed healthcare professionals, state-licensed pharmacies, or FDA-registered outsourcing facilities.
Glossary of terms:
- GLP-1: Glucagon-like peptide-1 is a gut-based hormone involved in the secretion of insulin to lower blood sugar levels typically elevated after meals.
- GLP-1 Ra: Glucagon-like peptide-1 receptor agonist. It mimics the actions of GLP-1.
