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Q&A

Weight Management Program

Questions & Answers on Weight Management Program

What is the Semaglutide Injection?

Semaglutide is a glucagon-like peptide (GLP-1) analog. GLP-1 is a hormone produced in the small intestine that stimulates insulin secretion and inhibits glucagon secretion, thereby lowering blood sugar. It is the active ingredient in the brand name medication known as Ozempic®, Wegovy®, and Rybelus®. At Biosymmetry, we offer the generic version of these expensive brand name mediation. The weekly injection helps regulate insulin and glycemic control as well as decreasing patient appetite.

Semaglutide originated as a treatment for type 2 diabetes. As of June 2021, the FDA approved semaglutide for weight loss as a supplement to other weight-loss treatment, including diet and exercise. Our providers will determine whether semaglutide is an appropriate part of your weight-loss plan.

If our providers find that you’re a candidate for semaglutide for weight loss, we will give you your first injection. From there, you can determine whether you prefer administering the weekly semaglutide injection yourself or receiving the injection at our clinic.

What are the effects of semaglutide?

Studies show that Semaglutide helps with:

  • Slowing stomach emptying
  • Control of cravings
  • Improves control of eating
  • Reduces appetite
  • Increasing insulin release
  • Improves glycemic control

Are there any side effects of semaglutide?

The side effects that you may experience may include: nausea, diarrhea, vomiting, constipation, stomach pain, headache, tiredness, upset stomach, dizziness, feeling bloated, gas, stomach flu, heartburn and in rare cases, pancreatitis.

Who can use semaglutide?

If you are healthy and not pregnant or lactating, or do not have a known allergy to any of the ingredients, you should be able to use it safely. However, make sure to discuss with your physician any other medications you are taking or any allergies or chronic health conditions you have prior to using semaglutide. Tell your prescribing physician if you or anyone in your family has or has ever had MTC (Multiple Endocrine Neoplasia syndrome type 2 or MEN2; a condition that causes tumors in more than one gland in the body).

How is semaglutide taken?

Typically, it is a once-weekly injection, but your particular dose and protocol will be determined by your prescribing provider.

How can I get the medication?

  1. Compounded semaglutide or trizepatide from a compounding pharmacy
  2. A Prescription for the name brand drug Ozempic/Wegovy (active ingredient semaglutide) or Mounjaro (active ingredient tirzepatide).

What are the benefits of the compounded semaglutide or tirzepatide?

  • No hassle at the pharmacy
  • No lines
  • No insurance hassles
  • No backordered medication

What are the possible drawbacks of compounded semaglutide or tirzepatide?

  • Out of pocket cost
  • May not be able to acsess semaglutide or tirzepatide from a compounding pharmacy in the future due to FDA regulations
  • However, if you are part of the 6-month Weight Management Full Program, this program will ensure you have a 6-month supply

What are the benefits of a Ozempic/Wegovy or Mounjaro prescription?

Insurance may cover some or all the cost

What are the possible drawbacks of Ozempic/Wegovy or Mounjaro prescription?

  • Risk of shortage
  • May need to go to multiple pharmacies to find in stock options due to shortages
  • Long lines at the pharmacy
  • Insurance coverage may change with each subsequent refill, from mostly covered to not covered at all

How much does it cost and will insurance cover it?

Our 6-month weight management program for compounded semaglutide is $1650 and includes monthly office visits, 6-months of medication guaranteed, weekly weigh ins if desired, and additional body comps. After 6 months, you can again enter the 6-month weight management program for $1650 or choose the monthly option to recieve compounded semaglutide or a prescription for Ozempic or Wegovy monthly option of $325 per month. So whether it’s the compounded semaglutide or a prescription for the name brand drug, it’s $325 monthly.

If you’re going the insurance route, we’ll submit the prescription to a pharmacy of your choice that has the medication and correct dosage in stock for $325 monthly, with the hope that insurance covers the rest of the cost. To check whether there’s a chance insurance will cover the name brand drug Wegovy, click here.

Additionally, if you attempt to use insurance for medication coverage, remember that the lower/starting does of Wegovy are in short supply per the manufacturer and insurance coverage is unlikely in a majority of cases. If insurance doesn’t cover Wegovy or your dose is not available, we can still get the medication for you in the compounded version for the same monthly cost of $325.

Either way, you’re guaranteed access to the medication for $325 each month – either via a compounding pharmacy or through a prescription for the name brand drug from a traditional pharmacy.

What is the 6 month Weight management program for compounded semaglutide and how does it work?

If you choose the 6-month weight management program and FDA regulations change such that we can no longer get the compounded semaglutide from the compounding pharmacy, we will still guarantee enough supplies of the semaglutide to get you through the 6 month program. If you don’t do the 6-month program and the compounded semaglutide becomes unavailable, we will be unable to provide you any semaglutide moving forward but can still give you a prescription in the hopes you can obtain insurance coverage.

How BioSymmetry is able to get "Generic" Ozempic/Wegovy? 🤔

We’ve received numerous questions about how we’re getting semaglutide, the active ingredient in Ozempic and Wegovy, since it is currently on backorder from the manufactor.

We order our semaglutide from a compounding pharmacy. Unsure what a compounding pharmacy offers; there is a good chance you have used medication from a compounding pharmacy before.

Compounding pharmacies offer:

  • Allergic to a dye or certain ingredient in a medication? Compounding pharmacies can recreate that medication without the dye or allergen
  • Have a child or elderly parent that can’t swallow the pill form of a medication? Compounding pharmacies can recreate the mediation in liquid form
  • Ever received Botox or filler at a doctor’s office? The topical numbing cream placed on the skin prior to treatment was made in a compounding pharmacy
  • Ever used bioidentical hormone replacement therapy (BHRT) from a compounding pharmacy?
  • Medications that are in short supply or national backorder, can be produced by compounding pharmacies

This last example is why we’re able to get semaglutide. It’s currently listed on the FDA’s shortage list, and as such, the FDA allows a compounding pharmacy to duplicate a commercially sold drug that’s currently unavailable or in short supply.

What happens if semaglutide is removed from the shortage list?

If brand name medications are taken off the FDA shortage list, it’s possible compounding pharmacies will no longer be allowed compound semaglutide. Another option maybe that compound pharmacies will offer semaglutide in combination with B-12 or L-carnitine, then they are making a materially different compound than the patented version of semaglutide manufactured by NovoNordisk and as such, compounding pharmacies maybe able to continue offering a novel version of semaglutide with this additive.

Which option will win out? FDA has not weighed in on these options yet.

Generic VS “Generic”

We may use the term generic when referring to our compounding pharmacy version of semaglutide. We are aware that generic within the context of pharmaceuticals can mean a drug that is being manufactured after a previous name-brand drug has lost its patent protection. That’s certainly not the case here because Ozempic and Wegovy have not lost their patent protection.

But we will sometimes reflexively refer to our semaglutide as generic because it is 1) an alternative way of saying the medication is not a name brand, which is certainly generic in some contexts and 2) less confusing for most patients. Regardless of whether we use the term generic or replicated or analogue, it is the same active ingredient whether it was created at a compounding pharmacy or at a large pharmaceutical company that makes “generic” drugs.

What are the Quality standards of compounding pharmacies?

In regards to the quality of medications produced by a compounding pharmacy, the facility we receive our compounded medications from is considered an “outsourcing facility”, as defined in The Drug Quality and Security Act, of 2013. That law created a new section, 503B, in the Federal Food, Drug, and Cosmetic Act. As such, an outsourcing facility is overseen and inspected by the FDA, along with state regulators.

Under the law, outsourcing compounding pharmacies must comply with section 503B and current good manufacturing practice (CGMP) requirements. In other words, they have very high standards to keep.

And we’ve had a great experience with our compounding pharmacies providing our compounded medications; the compounding pharmacies we use include both 503A & 503B. Our relationship with these pharmacies predates this particular drug.

Can I use insurance for theses medication options?

To be clear, we are not trying to encourage patients to go the compounded semaglutide route or discourage patients going the prescription route for the name brand Ozempic/Wegovy/Mounjaro, but we cannot overstate how convoluted and difficult and frustrating it will be to obtain these medications through a traditional pharmacy with insurance. You will be met with hurdles every step of the way and we will be unable to lower those barriers because those barriers are out of our control.

But no matter what happens, insurance coverage or not, you’re guaranteed access to the medication in some form with the monthly $325 (Ozempic/Wegovy/semaglutide) either via a compounding pharmacy or through a prescription for the name brand drug from a traditional pharmacy.

What is Tirzepatide?

Tirzepatide is a medication that can be administered through injections that initially were used to help treat patients with type 2 diabetes to support blood sugar level management. However, physicians quickly found out that tirzepatide offers weight loss benefits as well, making tirzepatide an effective addition to medical weight loss programs. It works both by lowering your blood sugar levels while simultaneously slowing down the digestive process, making it effective for weight loss. Slowing down the digestive system means that food stays in the system for longer, signaling to the brain that the body is fuller for longer. This, in turn, makes following a calorie-deficient diet much easier to maintain, which is one of the key components of a medical weight loss program.

How often do you inject Tirzepatide?

The most common administration of tirzepatide is through weekly injections. Typically, patients are started on a low dose (usually 2.5mg) weekly to make sure that the body does not experience bad reactions or side effects to the medication. This low dose is continued for at least four weeks and then may be gradually increased.

How long does it take for Tirzepatide to work?

When used alongside a calorie-deficient diet and regular exercise, patients usually begin to see results from tirzepatide within 8 to 12 weeks, although some patients may experience weight loss in the first month. Timelines of tirzepatide can vary greatly depending on how the patient responds to the medication. The result timeline for weight loss also greatly depends on how strict the patient is following a diet and the amount of physical activity.

Are there any side effects of Tirzepatide?

Moderate side effects of tirzepatide and semaglutide can include:

  • constipation or diarrhea
  • upset stomach, nausea, and vomiting
  • headaches
  • abdominal pain
  • fatigue
  • low blood sugar

More severe side effects of tirzepatide and semaglutide may include:

  • vision changes
  • pancreatitis
  • gallbladder issues
  • allergic reactions

Both these medications have boxed warnings for the risk of thyroid C-cell tumors. A boxed warning is the most serious warning from the FDA.

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