Medicines Optimisation Team

 

Prescribing available GLP-1 receptor agonists during national shortages:

Jan 2024 - National shortage of GLP1 Receptor Agonists

An updated National Patient Safety Alert (NatPSA) on the shortage of GLP-1 receptor agonists  issued on 3 January 2024 notes that supply of GLP-1 RAs is not expected to return to normal until at least the end of 2024.

Actions for clinicians and prescribers of GLP-1 RAs until supply issues have resolved can be found in the alert and should be completed by clinicians and prescribers as soon as possible and no later than 28 March 2024. The NatPSA alert should be read in full but some key points are noted below:

Community pharmacy colleagues have been advised:

• Not to suggest alternative injectable GLP-1 RAs or different dose even if they do have stock as per MSN directive.
• Not to suggest that patients routinely contact surgeries, DSNs or Prescription Ordering Direct (POD) service for a clinical review unless the patient is feeling unwell as a result of stopping GLP-1 RA.

Surgeries have been advised:

• That GLP-1 RAs should only be prescribed for their licensed indication.
• Rybelsus® (semaglutide) tablets are now available in sufficient quantities to support initiation of GLP-1 RA treatment in people with type 2 diabetes (T2DM) in whom new initiation of GLP-1 RA therapy would be clinically appropriate. Prescribe Rybelsus® tablets for new initiations of a GLP-1 RA (in line with NICE NG28).
• To identify patients prescribed Byetta® and Victoza® injections and (in line with NICE NG28) switch to Rybelsus® tablets.
• To counsel patients on any changes in drug, formulation, and dose regimen where appropriate (see additional information in the alert)
• To avoid switching between brands of injectable GLP-1 Ras and avoid substituting higher dose preparations by ‘doubling up’ or switching between strengths of a GLP- RA solely based on availability.
• To order stocks sensibly in line with demand during this time, limiting prescribing to minimise risk to the supply chain whilst acknowledging the needs of the patient.
• To encourage patients to engage with structured education and weight management programmes where available (details of locality arrangements to follow).
• To continue to undertake a review process (searches and template PILS have been sent to practices and are included as links below).
  Patients will be triaged with higher risk patients being proactively invited for review.

Prescribing Incentive Scheme FY 23/24 - Review of GLP-1s as response to national shortage – Supporting information

Prescribing Incentive Scheme FY 23/24 - Review of GLP-1s as response to national shortage – Information for Practices

GLP-1-stock-shortage-patient-information-leaflet-without-cover-letter

GLP-1-stock-shortage-patient-information-leaflet-with-cover-letter

Update March 2024: Glucagon-Like-Peptide 1 Receptor Agonist National
Shortage

Advice for those stopping GLP1's NHS leaflet - produced by Somerset ICB and approved for use across BSW

Diabetes UK have a FAQ factsheet for people affected by the shortages: Diabetes UK - FAQS - GLP-1 RA Shortages

Please continue to check Stock Shortages - Medicines (bswtogether.org.uk) for local updates as well as utilising the national information hosted by SPS Medicine Supply Tool Shortage of GLP-1 receptor agonists used in the management of type 2 diabetes (semaglutide, dulaglutide, liraglutide, exenatide) – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice [note SPS website requires users to register and log in)