Glucagon-like peptide-1 (GLP-1) analogues are in increasing demand worldwide. The limited availability of some of these medicines will last in Belgium until June 2024. Experts from the FAMHP's Unavailability Task Force issue the following recommendations.
Recommendations for (hospital) pharmacists and medical doctors (specialists)
- As long as the availability remains limited, priority should be given to the authorised indication of GLP-1 analogues for the treatment of type 2 diabetes, i.e. adult patients with inadequately regulated type 2 diabetes as an adjunct to diet and body exercise.
- GLP-1 analogues can also be prescribed in following conditions :
- overweight patients with a body mass index (BMI) higher than or equal to 35 kg/m²;
- overweight patients with a BMI higher than or equal to 30 kg/m² in combination with at least one weight-related comorbidity.
- Patients currently treated with GLP-1 analogues for obesity who met the above criteria at the start of their treatment may continue their treatment as planned. However, GLP-1 analogues registered for the treatment of diabetes mellitus can no longer be prescribed to patients who are being treated with GLP-1 analogues for obesity but who did not meet the above criteria at the start of their treatment. These patients should gradually reduce or discontinue their GLP-1 analogue-based therapy in consultation with their GP. GLP-1 analogue-based therapy for new obese patients meeting the above criteria must be initiated by an endocrinologist in a multidisciplinary setting; the first prescription (the initial prescription) can only be issued by this endocrinologist. The second and subsequent prescriptions can also be issued by the patient's GP.
- Following GLP-1 analogues can be used, depending on their availability:
- exenatide (Bydureon extended-release suspension for subcutaneous injection);
- semaglutide (Ozempic solution for subcutaneous injection);
- semaglutide (Rybelsus tablets).
Since 1 September 2022, the ban on cumulation between the different specialities in the incretin mimetic class (A-92) has been temporarily lifted by the National Institute for Health and Disability Insurance (NIHDI). This measure still applies.
Recommendations for patients
During this time of limited availability of GLP-1 analogues, your treatment may have to be adjusted. Your GP will examine whether your treatment needs to be adjusted or discontinued. We understand that this can cause inconvenience.
There is no need to worry as measures are being taken to ensure that GLP-1 analogues remain available for patients who need them most.
The Task Force strongly advises against buying these medicines online. The European Medicines Agency (EMA) and the FAMHP have received reports of falsified GLP-1 analogues in the EU. Belgian law clearly stipulates that prescription medicines may not be bought or sold online. However, you can reserve the medicine online, preferably through your referring pharmacist. If you choose to visit another pharmacy, please consult the list of pharmacies approved by the FAMHP on our website.
The FAMHP closely monitors the situation, both at national and European level.