Provider Briefing: The Ozempic Supply Situation in 2026

The Semaglutide supply disruption has been one of the most significant drug shortages in the past decade, affecting millions of patients with type 2 diabetes and creating downstream challenges for prescribers, pharmacies, and health systems. This briefing provides an evidence-based overview of where things stand in 2026 and practical guidance for managing your prescribing decisions.

Timeline: How We Got Here

Understanding the trajectory of the Ozempic shortage helps frame the current landscape:

• 2022: Initial supply constraints emerge as off-label prescribing for weight management surges alongside growing on-label demand for type 2 diabetes
• Early 2023: FDA officially adds Semaglutide injection products to its drug shortage list. Novo Nordisk acknowledges supply challenges and begins accelerating manufacturing investments
• 2023-2024: Peak shortage period. Multiple dose strengths intermittently unavailable. Starter doses (0.25 mg, 0.5 mg) most affected. Compounding pharmacies begin producing Semaglutide preparations, raising quality and safety concerns
• 2025: Novo Nordisk's $6+ billion manufacturing expansion begins to yield results. Supply of higher doses (1 mg, 2 mg) stabilizes in most markets. FDA takes action against certain compounding pharmacies
• Early 2026: Significant improvement across all dose strengths, though intermittent regional shortages persist, particularly for starter doses. FDA has removed some formulations from its active shortage list

Prescribing Implications

The ongoing supply variability creates several practical considerations for prescribers:

New Patient Starts

Initiating new patients on Ozempic requires starter doses (0.25 mg for 4 weeks, then 0.5 mg) that remain the most supply-constrained. Before writing a new Ozempic prescription, consider:

• Checking current availability using tools like Medfinder for Providers
• Discussing supply reality with the patient upfront to set expectations
• Having a backup plan if the initial prescription can't be filled
• Whether an alternative GLP-1 agonist with better current availability might be a more reliable first choice

Existing Patients

For patients already established on Ozempic at maintenance doses (1 mg or 2 mg), supply is generally more reliable. Key considerations:

• Encourage patients to refill early (within their insurance window) rather than waiting until their pen is empty
• If a patient reports inability to fill, consider whether a temporary switch to an alternative is preferable to a gap in therapy
• Dose gaps may require re-titration — a patient who misses several weeks of Semaglutide may experience return of GI side effects at their previous dose

Off-Label Weight Management Prescribing

Given that off-label demand for weight loss has been a primary driver of the shortage, prescribers should be thoughtful about:

• Using Wegovy (Semaglutide 2.4 mg, FDA-approved for weight management) rather than Ozempic for patients whose primary indication is obesity
• Considering Zepbound (Tirzepatide) as an alternative for weight management that doesn't draw from the Ozempic supply
• Documenting the clinical indication clearly to support appropriate insurance coverage

Current Availability Picture

As of early 2026, the availability landscape for Ozempic by dose:

• 0.25 mg/0.5 mg pen: Intermittently available. Regional variability remains high. This pen is used for dose initiation and is most affected by new patient demand.
• 1 mg pen: Generally available at most retail and specialty pharmacies
• 2 mg pen: Generally available. Fewer patients use this dose, so supply-demand balance is more favorable.

Availability varies by pharmacy type. Independent and specialty pharmacies may have better stock than large retail chains in some markets. Mail-order pharmacies connected to major PBMs often have the most consistent supply.

Cost and Access Considerations

Cost remains a barrier for many patients, which indirectly affects adherence and contributes to the availability challenge when patients seek lower-cost sources:

• Cash price: $850–$1,100/month per pen
• Commercial insurance: Most plans cover Ozempic for type 2 diabetes with prior authorization. Copays range from $25–$150/month.
• Novo Nordisk Savings Card: Eligible commercially insured patients may pay as little as $25/fill (not valid for government insurance)
• Medicare Part D: Covered for diabetes with PA. No manufacturer copay card assistance for government-insured patients. The Inflation Reduction Act's $2,000 annual out-of-pocket cap provides meaningful relief.
• NovoCare Patient Assistance Program: Free medication for uninsured patients meeting income criteria (≤400% FPL)

For a patient-facing resource on cost savings, you can direct patients to our guide on how to save money on Ozempic.

Tools and Resources for Providers

Several tools can help streamline the process of getting patients their medication:

Medfinder for Providers

Medfinder offers real-time pharmacy stock data that can help your team:

• Check Ozempic availability across pharmacies in your patient's area before prescribing
• Direct patients to specific pharmacies that have their dose in stock
• Reduce the back-and-forth of rejected prescriptions and pharmacy transfers

Therapeutic Alternatives Quick Reference

When Ozempic isn't available, these alternatives may be appropriate depending on the patient's clinical profile:

• Mounjaro (Tirzepatide): Dual GIP/GLP-1 agonist. Weekly injection. Strong A1C reduction and weight loss data. May require prior auth. Generally good availability in 2026.
• Trulicity (Dulaglutide): GLP-1 agonist. Weekly injection. Well-established safety profile. Slightly less effective than Semaglutide for A1C and weight but widely available.
• Rybelsus (Oral Semaglutide): Same molecule, oral formulation. Daily dosing with fasting requirements. Lower bioavailability than injection. Better supply than injectable Semaglutide.
• Victoza (Liraglutide): GLP-1 agonist. Daily injection. Proven cardiovascular benefit. Oldest in class with most long-term data. Readily available.

For a detailed comparison, see our guide on alternatives to Ozempic.

Looking Ahead

Several developments may affect the Ozempic supply landscape through the rest of 2026 and beyond:

• Novo Nordisk manufacturing expansion: Additional production capacity is expected to come fully online through 2026-2027, which should meaningfully improve supply
• Competitive landscape: Growing use of Mounjaro/Zepbound and potential new GLP-1 and dual-agonist entrants may reduce demand pressure on Ozempic specifically
• Regulatory actions: FDA oversight of compounding pharmacies producing Semaglutide continues to evolve, which may affect the gray-market supply that some patients have turned to
• Biosimilar timeline: Generic/biosimilar Semaglutide is not expected before 2031-2032 based on current patent protections

Final Thoughts

The Ozempic shortage has tested providers' ability to adapt prescribing strategies, manage patient expectations, and navigate a constrained formulary. While the situation in 2026 is substantially better than 2023-2024, proactive management remains important.

Using tools like Medfinder for Providers, staying current on supply developments, and having clear protocols for therapeutic substitution will help your practice deliver consistent care despite ongoing variability.

For a practical guide on helping patients navigate availability, see how to help your patients find Ozempic in stock.