A1c Lowering and Weight Loss at Once-Weekly Convenience: Ozempic

By Jeemin Kwon, Ann Carracher, and Payal Marathe

People with type 2 can now get the once-weekly injectable in the US. The latest GLP-1 to show strong A1c-lowering and weight loss, Ozempic will also reach Europe in the second half of 2018

Many in the diabetes world are buzzing about Novo Nordisk’s once-weekly GLP-1 injectable drug, Ozempic, which is now available in US pharmacies, following FDA approval two months ago for people with type 2 diabetes. Ozempic was also recently approved in Europe for people with type 2 diabetes, with a launch expected in the second half of 2018.

In clinical trials, Ozempic led to greater A1c reduction and weight loss than Bydureon and Trulicity. In the most recent direct comparison trial against Trulicity, Ozempic users had an average 1.8% drop in A1c compared to a 1.4% drop for Trulicity users (both started at an A1c of 8.2%), and lost 10-14 pounds with Ozempic (5-7% weight loss) compared to 5-7 pounds lost on Trulicity (2-3% weight loss).

Additionally, Ozempic has data from a two-year heart safety outcomes trial on its label. The heart safety trial, which compared Ozempic to placebo in patients with existing heart disease, found a 5-42% reduction in risk for non-fatal heart attacks, non-fatal strokes, or heart-related death. To strengthen the evidence of Ozempic’s heart benefit, Novo Nordisk is planning a major heart health study that will start later in 2018.

Ozempic comes in a FlexTouch pen, similar to the pens for Novo Nordisk’s once-daily injectable GLP-1, Victoza. In the US, Ozempic will be more expensive than Victoza, but priced similarly to Trulicity, another once-weekly GLP-1. While Novo Nordisk is still negotiating with insurance companies to determine reimbursement rates, people with private insurance could pay as little as $25 per month with the Ozempic savings card (maximum savings: $150 per prescription).  

As a reminder, Ozempic is the latest in a class of type 2 diabetes drugs called GLP-1 agonists, which include once-weekly Bydureon and Trulicity, once-daily Victoza and Lyxumia, and twice-daily Byetta. So far, all of these drugs require injections. Novo Nordisk is working on a pill version of Ozempic, but it is still four or five years away from being available in pharmacies.

The GLP-1 class has become more popular with patients able to get it in the US, likely because of the weight loss associated with these drugs and the stability that it brings to diabetes management. diaTribe Advisory Board member Dr. Steve Edelman has previously said, “We have new approved fixed combinations, implantable micro pumps that deliver exenatide for a year, we have once-weekly agents, and all kinds of new options. If I had to pick one class with the biggest effect, I would have to pick GLP-1’s.”