Ever have a commercial jingle stuck in your ahead? If you haven’t heard the Ozempic jingle feel free to listen here. Manufactured by Novo Nordisk, Ozempic is prescribed to patients to treat Type 2 diabetes and to reduce the risk of adverse cardiovascular events. Novo Nordisk recommends patients also engage in diet and exercise while taking Ozempic.[i] While Ozempic is not approved as a weight loss drug, weight loss was noted as a common side effect. [ii] Ozempic and other drugs used to treat diabetes have garnered the attention of many celebrities.[iii]
What’s the Concern
With any medication it is important to be prescribed as indicated. When patients take medications for reasons other than FDA approved uses it’s called Off-Label use. Off-Label use can pose potentially life-threatening risks to patients when taking medication they do not need. Possible side effects may include Pancreatitis, hypoglycemia, kidney problems and more…[i]
Wegovy is a drug containing ingredients similar to Ozempic, but was approved by the FDA on June 4, 2021 for weight loss. Some plans do not cover Wegovy and/or have strict criteria in order for patients to be eligible to receive this drug. There are a handful of other medications use to treat diabetes that we should be on the lookout for off-label use for weight loss treatment including Mounjaro, Trulicity, and many more.
What to look for?
- Patients who do not have a history of diabetes
- Prescribers who are outliers for any and all of the known drugs being used off-label for weight loss treatment including, but not limited to Ozempic, Mounjaro, Trulicity and more.
- Any Pharmacies that stand out as outliers and are potentially colluding with prescribers
- Counterfeit drugs on the market (lacking valid lot numbers, packages don’t look right-blurred letters and crooked labels, no bar code and more)
Healthcare Fraud Shield is capturing this behavior in a variety of ways. Here is just a few of the MANY ways we capture this type of behavior:
Alert: [5256-01] – OFF-LABEL USE OF OZEMPIC: This Alert identifies NDC’s for the drug Ozempic without a supporting diagnosis related to Type 2 diabetes, as it’s potentially being prescribed off-label for non-FDA approved weight loss. (PRESCRIBER ALERT)
Alert: [5256-20] – OUTLIER BY PRESCRIBER, OZEMPIC (SEMAGLUTIDE): This Alert identifies providers excessively prescribing Ozempic (Semaglutide) NDC’s, when compared to their peers. (PRESCRIBER COMPARISON)
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