Written by Kathleen Doheny / Originally published on WebMD

9 min read

June 3, 2024 – If you’re one of the many trying to start – or refill – a Wegovy or Zepbound prescription for weight loss, it’s tough out there. 

The new reality? Spending hours on the telephone with pharmacists and insurance company people.

Driving to pharmacies several miles away, several hours away, or even to a nearby state is a regular task. Many join social media groups to find out where the best supplies are, hunting for clues like a treasure seeker.

These are the new routines for those trying to secure prescriptions of the blockbuster GLP-1 weight loss drugs Wegovy and Zepbound, approved for treating obesity. Ongoing shortages are frustrating doctors, patients, and pharmacists. Many describe the situation as a roller coaster—one day, the medication is available, the next day, not, with some doses in shorter supply than others.

Here’s how six people managed to fill their prescriptions, despite all the obstacles.

Elizabeth Swanson: Ignore the Social Stigma and Keep Calling

When it’s time for Elizabeth Swanson, 57, a Seattle homemaker, to renew her Zepbound prescription for another month, she’s on the phone, sometimes for hours, calling multiple pharmacies to find a refill. She’s on a timeline. “You can’t fill it until the insurance says it’s been enough days,” she said. With hers, they won’t refill until the 28-day mark. 

Before those marathon hold times, she said, she has to overcome the feelings of stigma. “People are still shaming people for being on it. There’s so much social media shame about it.” 

She’s now at her goal, 58 pounds down, and wants to stay on the medication as a maintenance tool. When patients stop the medication, many say the “food noise” the drugs drown out returns, and so does the unwanted weight. 

Swanson went on Zepbound in January, after losing 30 pounds on her own and by taking Mounjaro, which has the same active ingredient as Zepbound (tirzepatide). But Mounjaro is a diabetes drug prescribed off-label for weight loss. Then, Mounjaro became hard to find and Zepbound was easy to find – for a while.

“The minute I changed doses [to Zepbound], everything went bananas,” she said. To get her refills, she – and her husband – have traveled to pharmacies all over the state of Washington. 

“I have actually paid a telehealth doctor in California so my husband could pick it up there.” First, she paid $75 for the telehealth visit so that doctor could write and submit the prescription. Now, she’s had to switch to Wegovy, as Zepbound isn’t available in the dose she needs. Wegovy is the brand name for semaglutide, which is approved for weight loss. Its sister, drug, Ozempic, is approved for diabetes treatment.

The bright spot for Swanson: She’s met her deductible, so she no longer has out-of-pocket costs. 

Adolfo Estrada: Move Fast When Supply Is Found

Offered Zepbound or Wegovy by his doctor, Adolfo Estrada, a 29-year-old product manager in Seattle, opted for Zepbound. His employer’s insurance didn’t cover either medication. With a discount coupon, Zepbound, at $550 a month, cost less than Wegovy, so he went with it. (Both Novo Norkisk which makes Wegovy, and Lilly, which makes Zepbound, offer savings programs to those eligible.) 

He’d heard about the shortage, but soon after his doctor called in the prescription to a nearby pharmacy, he got a call it was ready. “They had one box left,” he recalled. “I was like, ‘Put my name on it, and I’ll be right there.’” Then came month 2, and supplies were scarce. When he checked the local pharmacy, it had two boxes left, so he went and grabbed one.

Then the shortage got bad again, and Estrada’s dose needed to be increased to 5 milligrams, which was in very short supply. His doctor said they could switch him to Ozempic (semaglutide, approved for diabetes but often prescribed off-label for weight loss) for a few months. He agreed, but then the local pharmacy called and said it had the needed dose after all. So he’ll stay on Zepbound.

He’ll also keep paying $550 a month. On the medication, he said, he makes healthier decisions. “Before, I ate a lot of fast food,” he said. “I would say it’s almost day and night for me. We’re 2 months in, and I think I’m down around 40 pounds,” he said, halfway to his goal.

Although he’s set for now, he stays alert for other ideas on finding refills. “I’ve heard a lot have had luck with third-party services [such as Medfinder and RxBuddy]” He’s also noticed many Facebook groups and Reddit threads devoted to finding supplies and sharing information.

Sofia Spieler: Almost Like Getting Taylor Swift Tickets

Once she’s finished the third shot of the four-pack of Wegovy and it’s time to order a refill, Sofia Spieler, 34, a public relations professional and stroke survivor in Boston, said she’s always nervous. She’s already begun calling around to see who might have supplies.

Her stroke, 3 years ago, left her unable to exercise regularly during recovery, and her weight increased to 297 pounds. After losing 10 pounds on her own, she’s now lost another 23 on Wegovy and wants to stay on it to lose more. Insurance approval was prompt, and her copay is $25. 

But before a recent refill was needed, her usual pharmacy told her they didn’t know if anyone would have it. “I started calling around like crazy,” she said, trying other pharmacies. Nothing. She visited local Facebook groups to see if anyone knew of supplies. Her posts were removed, she said, when her comments were mistaken for medical advice. 

Recently, she circled back to a pharmacy she had called that didn’t have supply before, with just 2 days before she needed her next shot. As the pharmacy worker was explaining to her how they track down the medications by computer, he checked online and found two of the four-packs at the dose Spieler needed available for ordering. He clicked to order, and they both knew the supply might be gone before the order went through. As instructed, she called back the next day as the pharmacy was unloading supplies. Her refill was there. The pharmacy workers shared her joy at the news.

“It was almost like they are Taylor Swift tickets,” she said.

Christine Pickett: “Pray and Call the Pharmacist”

Christine Pickett, 54, lives in a rural Midwestern town, with just four local pharmacies. She’s often driven 30 miles one way to get the medication. Her advice: “Once you take that last shot, pray and call the pharmacist to renew.” 

She’s been on both Wegovy and Zepbound, but on Wegovy the longest. Over the past 18 months, she’s lost 75 pounds, with just 20 to go to reach her goal. With her insurance, the copay is $25 a month. 

The best news she’s gotten lately: Her doctor has been able to write a prescription for 3 months at a time, so the monthly scramble isn’t necessary.

Paola Comer: Patience Is Crucial

Paola Comer, 49, of Boston, works out 7 days a week, alternating a stationary bike, rower, and treadmill with strength training and yoga. She’s run two half-marathons. Yet her polycystic ovary syndrome (PCOS), a condition marked by insulin resistance, makes losing weight difficult. 

First prescribed Ozempic, Comer said her insurance covered it for a copay of $25 monthly. Then, in January, her insurance said it would no longer cover her Ozempic. So her doctor prescribed Zepbound. Insurance declined approval, then approved. But there was another barrier: no supply.

“I’m still waiting for it,” Comer said in mid-May. So her doctor prescribed Wegovy. Insurance approved it, but CVS didn’t have her dose, 1 milligram, which they said was in high demand. The FDA lists that dose of Wegovy as having limited availability with no estimate of when supplies will rebound. Luckily for Comer, another CVS, 15 miles away, had it, so she drove to get it.

Next, her doctor decided she should increase to the 1.7-milligram dose, and it was easier to get. The FDA says that dose is readily available. Her copay is now usually $25 monthly, but she once had to pay $1,500 for a month’s supply of the 1-milligram dose. Best advice? Take detailed notes when you talk to your insurance company. “I would keep logs,” she said, noting the date she talked to them, the topic, the decisions, and other details.

Aaron Holloway: A Scramble ‘Every Single Month’

“Every single month, it’s been kind of a scramble to figure out where I can refill my prescription,” said Aaron Holloway, 38, a software developer in Seattle who began taking Zepbound 3 months ago. Like others, he’s had to call around to find the medication. As he puts it: “It’s the most effort you’ve had to make to get a prescription.”

He’s had extra frustrations. “There was a hacking attempt on the health care system that runs the [discount] coupons, and systems were down for over a week.” If they couldn’t process the coupon, the pharmacy workers told him, the cost would be $1,700 a month. He called at least 10 pharmacies, he said, but couldn’t find anyone who could process the coupons.

He waited to start the medication until the coupon could be processed, as his employer doesn’t cover the medications. With the coupon, he pays $550. Despite the expense, he said the medication, along with working with nutritionists and exercising, has helped him lose a fair amount of weight already.

His best advice: “Be nice to the pharmacist.” Most really are trying to help, and they can’t control supply and demand.

Where Else to Find Help

Refer to shortage lists: The FDA lists drug shortages, searchable by dose and generic name – tirzepatide for Zepbound, semaglutide for Wegovy. Zepbound’s shortage is expected to continue until the end of June, according to the FDA, with no prediction for how long the Wegovy shortage will continue.

Novo Nordisk posts a supply update on Wegovy, and Lilly posts one for Zepbound.

Ask Your Doctor or Health Coach

Megan Melo, MD, a family and obesity medicine doctor at Phinney Primary Care and Wellness in Seattle, is one of those doctors that patients say goes the extra mile for them. “I have someone in my office who does the prior authorizations,” she said. 

When someone asks if the prescription can be sent to another pharmacy, she said her office accommodates that. “Then patients will share information with me [about supplies]. If I know who needs it, I tell them – hey, Fred Meyer [for instance] just got a shipment.”

Melo also keeps tabs on which pharmacies have higher stock and which are better at handling discount coupons. With that information, she can suggest an ideal pharmacy for a patient, based on the medication and dose prescribed and whether they need a coupon.

Likewise, Catherine Toomer, MD, a family medicine doctor and weight care specialist in South Carolina, asks her assistant to enter a patient’s ZIP code and call pharmacies within 10-15 miles to check supplies. If supplies are found, she sends the prescription right away. “It doesn’t take a lot of time, and I purposely leave a chunk of time in my day to do this.” 

She also gives patients her number so they can text her if they find the medication at a nearby pharmacy. Then she can send the prescription order there right away.

If a patient is covered and their insurance allows 3-month supplies, usually by mail order, and the pharmacy has the quantity, it’s possible to write a 3-month prescription, Melo said, reducing monthly anxiety. But “my patients using cash plus a coupon usually can only fill 1 month at the discounted price.” When starting out, people change doses every 1 to 3 months to keep the drug working well, so a 3-month prescription isn’t always feasible, she said.

Janele LeClair, a digital health coach at Omada Health, a virtual care program, has addressed the anxiety of those who can’t find a refill and must go without the medication for a time. When a patient in this situation consulted her recently, “I reassured her she did in fact have the tools, that she could do it on her own if that happened,” LeClair said. 

She advised her to make a list of all the changes she had made. She discovered she had a huge list of weight loss strategies – getting enough protein, sleeping enough, managing stress – and her anxiety declined until she could get a refill.

SOURCES:

Elizabeth Swanson, 57, Seattle.
Adolfo Estrada, 29, Seattle.
Sofia Spieler, 34, Boston.
Christine Pickett, 54.
Paola Comer, 49, Boston.
Aaron Holloway, 38, Seattle.
FDA: “FDA Drug Shortages.”
Novo Nordisk.
Lilly.
Megan Melo, MD, family and obesity medicine doctor, Phinney Primary Care and Wellness, Seattle. 
Catherine Toomer, MD, family medicine doctor and weight care specialist, South Carolina.
Janele LeClair, digital health coach, Omada Health.