A promising new diabetes drug touted as a powerful rival to a weight-loss phenomenon has landed in Australia.
But experts warn it won’t come cheap and, if it follows the path of Ozempic, could be out of reach for those who need it most.
Mounjaro is manufactured by international pharmaceutical firm Eli Lilly and health experts have lauded its arrival as part of a “new frontier” in the treatment of type 2 diabetes.
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The once-a-week injectable has also made headlines as an “off-label” solution for people battling obesity.
One US expert even declared Mounjaro “King Kong” when compared with “the gorilla” of semaglutide, the key ingredient in competitors including Ozempic — which was created as a diabetes treatment but gained popularity as a weight-loss solution — and its sister drug, Wegovy.
But experts are concerned GPs could prescribe it to people looking to lose weight, and it will become inaccessible for diabetes sufferers.
Mounjaro’s appearance at pharmacy dispensaries comes amid shortages of the Hollywood-backed Ozempic, which its producer Novo Nordisk has flagged will drag on into 2024.
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What is type two diabetes?
Type 2 diabetes develops when the body loses the ability to make insulin and stops using it efficiently.
Insulin, a hormone, controls the amount of glucose (sugar) in the blood.
Having blood sugar levels too high for long periods can lead to a range of long-term health complications, including organ damage and the deterioration of blood vessels, leading to heart attack, stroke, and issues with the kidneys and eyes.
According to Diabetes Australia, the number of people living with diabetes in this country has surged to 1.3 million, with case numbers increasing more than 220 per cent since 2000.
“The diabetes epidemic is one of the largest, and most complex, health challenges Australia has faced,” the association said.
How does Mounjaro work?
Simply, Mounjaro — the brand name for tirzepatide — helps the body control blood glucose levels and suppress appetite.
Its success as an off-label weight-loss drug has been attributed to tirzepatide’s dual action.
Unlike single-receptor agonist semaglutide, Mounjaro activates two receptors — GIP and GLP-1 — at the same time.
The GIP hormone induces insulin when blood sugar levels are high.
The GLP-1 has actions in several areas of the body including the pancreas and brain, affecting glucose and appetite.
“The first side-effect I noticed within hours of taking my first shot was the ‘food noise’ (was silenced),” one person who has been taking Mounjaro for six months detailed on TikTok, where many have shared their experiences.
“I used to wake up in the morning and think about what am I going to eat today, when am I going to eat, what’s going to be for lunch, what’s going to be for dinner?
“I thought everybody lived that way. I thought I was a foodie. No, that ‘food noise’ is not normal for most people.”
Mounjaro has arrived in Australia. Credit: 7NEWS
Mounjaro trials by the manufacturer found overweight patients with diabetes lost 15.7 per cent (an average 15.6kg) of their body weight, while another test found tirzepatide helped overweight patients without diabetes trim more than 20 per cent of their body weight.
One diabetes expert said the results were on par with bariatric surgery and are more than sufficient to help people prevent or delay type 2 diabetes.
The most common side-effects of Mounjaro include nausea and diarrhoea, but other complaints including vomiting, constipation, indigestion and stomach pain have also been raised.
Eli Lilly has played down Mounjaro’s use as a weight-loss miracle drug, saying it “is not indicated for the treatment of obesity or weight reduction”.
“While an added benefit of Mounjaro is weight loss, it needs to be made clear that in Australia this drug is indicated for type 2 diabetes management,” Australian Diabetes Society chief executive Sof Andrikopolous said.
Why are experts are keen on it as a diabetes drug?
Andrikopolous told 7NEWS.com.au the society is “very confident” Mounjaro will have a “significant and positive benefit for people with type 2 diabetes”.
“This is a significant time in type 2 diabetes management as we continue to get new drugs and new classes of drugs to treat high blood glucose and consequent complications,” Andrikopolous said.
While the first approach to addressing the disease is always tied to lifestyle — think exercise and food choices — and metformin is often the main first-line medication prescribed, contemporary options offer “new hope” when other avenues have been exhausted.
“Weight loss is an important therapeutic goal for many people and is essential for some people to manage, prevent, or delay type 2 diabetes,” Diabetes Australia said.
“Approved medications that help people manage type 2 diabetes, or prevent the condition, offer new hope”.
How can you get Mounjaro?
Australia’s Therapeutics Goods Administration (TGA) approved Mounjaro for the treatment of type 2 diabetes in December 2022 and it is currently only available via prescription.
It is available in vials and is injected once a week.
Dosages will vary depending on a patient’s personal situation.
Several pharmacies told 7NEWS.com.au they were not keeping the item in stock given its cost, current low demand and the different dosages that can be prescribed, but could easily order it in when needed.
Diabetes treatment Mounjaro has been available in the US for some time, and people have detailed their experiences with it. Credit: Supplied
I don’t have type 2 diabetes. Can my doctor prescribe it for weight loss?
The TGA told 7NEWS.com.au Mounjaro is “not approved for use for weight loss”, but conceded it is ultimately up to GPs to make that call.
“Prescribing a medicine for an indication that has not been approved by the TGA, known as off-label prescribing, is not illegal,” a spokesperson said.
“It is not the role of the TGA to regulate the clinical decisions of health professionals, and we are unable to prevent doctors from using their clinical judgement to prescribe medicines for other health conditions.”
The Australian Medical Association says people who want to lose weight for health reasons should discuss choices with their GP.
“Treatment options should always be discussed in the context of an individual’s broader medical history and personal circumstances,” AMA president Professor Steve Robson said.
“There is no silver bullet to tackling obesity and the AMA supports comprehensive and broad public health interventions to prevent obesity.”
Mounjaro is not on the Pharmaceutical Benefits Scheme (PBS), with a bid for its inclusion knocked back earlier this year.
It will cost Australians about $320 a month to access but, as a private prescription, it is understood the final price will be determined by pharmacies that can stock it.
The US Food and Drug Administration has also approved it as a type 2 diabetes treatment but, similarly to Australia, is yet to approve it as a weight-loss drug.
Reports suggest Americans without insurance are paying $A1575 for a one-month supply.
Despite the PBS setback, Eli Lilly made the decision to launch Mounjaro as a private prescription.
“We are committed to making this medicine accessible for adult patients living with type 2 diabetes and our ultimate goal is to secure reimbursement on the PBS,” the firm’s general manager for Australia, Tori Brown said.
Eli Lilly says Mounjaro is ‘not indicated for the treatment of obesity or weight reduction’. Credit: 7NEWS
The Royal Australian College of General Practitioners hopes it will be added to the PBS soon.
“This is a development in the management of type 2 diabetes that expands possible therapy options and for full access we await PBS approval to reduce financial burdens to appropriate patients,” RACGP chair Dr Garry Deed said.
“It, however, is not the only diabetes management option available to patients, but it is currently a unique agent in its own class.”
Why the timing of Mounjaro’s arrival could be important
Mounjaro’s arrival in Australia comes after the TGA warned about supply issues for Ozempic.
The TGA said the rapid increase in prescriptions for off-label Ozempic use is largely to blame for the shortages and doctors have even been advised not to prescribe it to new patients.
“With the recent shortage of Ozempic … we have strongly recommended that health professionals refrain from off-label prescribing and prioritise patients with type 2 diabetes who need it most,” a TGA spokesperson said.
Supply shortages are expected to drag on into 2024.
“It is unfortunate that Ozempic continues to be on the shortages list on the TGA and we are working closely with the TGA and other key stakeholders to ensure that people with type 2 diabetes are able to access the drug,” Andrikopolous said.
“The arrival of Mounjaro will hopefully give people with type 2 diabetes another option by which they can effectively manage their blood glucose levels.”
Deed said drug shortages “may be an ongoing problem” and said diabetes patients should be a priority.
“At this time we are emphasising that these drugs are indicated for the management of diabetes, and if we can focus on this group of people then supply may remain stable enough that they can get their necessary drugs,” Deed said.
Lilly Australia told 7NEWS.com.au “we believe we have sufficient ongoing supply to launch Mounjaro for people with type 2 diabetes in Australia and are committed to managing this carefully”.
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