Yuval (all the names of the interviewees in the article have been changed and their real names are kept in the system), a lawyer in her 30s from the center of the country, lives from diet to diet. She is not obese, but it does not matter to her low self-esteem. “I barely weigh 55 pounds, but in my head I always feel like a fat cow,” she says. “I always start a diet with enthusiasm, and after a few days it fades. It doesn’t matter how much I eat or don’t eat. I don’t like my body.”
About two months ago, a friend told her about osmic – a drug intended for overweight diabetics. “He gave me one shot to try, and I really felt like I didn’t want to eat,” says Yuval. “But what was the problem? It is prescribed by a doctor and only after an in-depth examination. But there is a black market and a lot of combos that allow you to get the shot for a lot of money. I bought the last shot from a pharmacist who works at one of the pharma chains. “.
Yuval pays about NIS 3,000 every month to get the shot, but in recent days the price on the black market has jumped to NIS 5,000. Given the demand, the price is not expected to stop there. “People spend all their salary, take out loans from the banks and the gray market,” says Yuval. “I sold jewelry to fund the injection. It’s worth every penny to me.”
“Osmic caused me to lose eight kilograms in two months,” says one of the users of the drug. “I tried every diet in the world, I just went down with it. It kind of closes my stomach. I feel lost without her“
But the price, Yuval says, she does not pay only in shekels. A few days ago, after injecting a large amount of osmic, she felt unwell: nausea, dizziness, vomiting. These are known side effects of the drug, but ones that may also be related to treatment done without the involvement of a doctor who knows how to adjust the injection and the amounts to the patient. This led Yuval to the emergency room, where she was hospitalized for the night for observation. “It can endanger my health, but I can not stop using it,” she says. “I became an addict, an Osmic drug addict.”
“I tried every diet in the world, only with this drug I went down”
Ozempic (medical name ozempic) has been marketed in Israel for almost six months as a drug intended for patients with type 2 diabetes (non-insulin dependent diabetes) who are overweight, and can get it by prescription. “The drug actually mimics the hormone GLP-1 we have in the body,” explains Dr. Vardit Kalmero of Doctor of Medicine, a clinical pharmacist and expert in information and drug therapy. The body’s response to the sugar that comes from food. ”
And how does this relate to weight?
“These are hormones that are secreted from the digestive system while eating, and have a great effect on regulating appetite. In practice, they reduce the feeling of hunger in the brain and also in digestive processes. They slow down gastric function and cause food to stay longer in the digestive system, which increases satiety.” .
The best-known drug in the group known as “GLP-1 receptor agonists” is Saxenda, which is approved for the treatment of overweight (with a doctor’s prescription). This is an injection that has a maximum cost of NIS 1,122 (for a package of five solutions). It is given by subcutaneous injection once a day at a dose of 3 mg, and according to studies promises a 5 percent weight loss after the first four months of treatment and about 11 percent after a year.
The osmic, on the other hand, is only for diabetics who are obese. It is injected once a week, in a dose ranging from 0.25 to 1 mg. There are no official data on the effectiveness of osmic, but doctors and patients attest to its success. “The treatment with these drugs is long-term,” says Dr. Pazit Shaked, a clinical pharmacist and drug treatment expert. “Studies show that when people stop using them after 20 weeks or more, they regain all the weight gradually over time. An unusual way to obtain the drug legally for a person who is not diabetic, “but must be purchased at full price and it also requires a doctor’s prescription and Form 29C – the doctor requests approval from the Ministry of Health to use the drug not according to its official label in Israel.”
“I can get any medicine in seconds, but for Osmic it sometimes takes a few days,” says one telegram trader. “It is the most sought after drug on the black market. I get hundreds of inquiries a day “
The maximum price of Ozmfik in pharmacies is NIS 496 for a dose of one milligram (before a discount for HMO insureds). The fact that it is cheaper than the sexanda, injected only once a week and very effective according to the testimonials of its users, has made the osmic a preferred option for weight loss injectors. Ronit, 20, who buys the osmic together with a friend and injects each other with two milligrams a month, says that the drug “made me lose eight kilograms in two months. I tried every diet in the world, only with this drug did I lose weight. It’s a fact. “We are addicted to osmic, I feel lost without it.”
But in recent months the demand for it in the market has risen, as has the price. A family doctor says he was recently asked to moderate the prescription of the drug to patients, in an attempt to eradicate the misuse of prescriptions on the black market.
Sima, a mother of three who works in a large government office, tried to get the medicine from the family doctor, but was refused because she is not diabetic or meets the exceptional criteria. “He did blood tests on me, weighed me and said I didn’t need the injection. No matter how much I begged – nothing helped.” She finally bought the medicine for NIS 4,000 from a pharmacist. “For women like me who want to lose weight and look good,” she says, “osmic is worth more than gold.”
“Your chances of getting an osmic on the black market are getting harder by the day,” says Dan, a resident of Tel Aviv. “It’s a crazy, even hallucinatory chase. If you managed to get a quarter of a milligram or half a milligram it’s sometimes wow. I bought a pharmacist for NIS 2,500, I have friends who bought from doctors. It’s a very lucrative business. People like me are willing to pay any price to get an osmic, then Prices are going up and up. ”
“What does it matter how I get it? It’s none of your business”
The merchants at Osmic are usually brokers who work with pharmacists and doctors. The trader receives a prescription from a doctor, purchases the injection, sells it on the black market (telegram or word of mouth) and shares the profits with the doctor. Pharmacists involved in the market do so at an estimated rate through collaborating with merchants, stealing or falsifying prescriptions (in February this year, two pharmacists from Ichilov were arrested on suspicion of falsifying prescriptions of painkillers intended for Holocaust survivors). The drug is delivered to customers through taxi drivers or couriers, and the money is given in cash or transferred by telegram.
“We buy the medicine from a good friend who has a combination with his family doctor,” says Ronit, who buys the osmic with her friend. “He gives us the prescription and a HMO card, and we buy it at the pharmacy. We pay NIS 1,500 per milligram.”
“I buy a medicine for NIS 500, use two injections and sell the others for 2,000,” says a diabetic who trades at Ozmfik. “I get calls from girls Who are willing to pay NIS 5,000 for the medicine as well“
A pharmacist from the south of the country involved in the trade in Ozmfik insisted to us that “everything is legal, I do not steal from anyone. What does it matter how I get it? It really does not matter to you. I have my ways. There are also doctors who trade it. People need medicine and we “They help them get it. It’s true that I benefit from it. How much? It can reach tens of thousands of shekels.”
“This is the most sought-after drug on the black market of drugs,” says Lior, who trades at Osmic on the Telegram. “I get hundreds of inquiries a day from people who are willing to pay a lot of money for it. I can get any medicine in seconds, but for Osmic it sometimes takes a few days. It’s the hottest hit today. If at first it cost NIS 1,500, today people are willing to pay both 4,000 and 5,000 “For a pack of one milligram. Some people buy two, three milligrams a month.”
Other dealers in the drug, Lior says, are diabetics who are eligible for a prescription but use it to make a profit. “I buy a medicine for NIS 500, use two injections of a quarter of a milligram, and sell the other two for NIS 1,500, sometimes for NIS 2,000,” says Yoav, a diabetic who became a trader at Ozmfik. “There is a crazy demand, people are willing to pay any price. You do not understand how many calls a day I get from young girls, bursting with money, who are looking for the medicine and are willing to pay 5,000 shekels for it as well.”
“There is no miracle cure for weight loss”
Although the osmic’s effectiveness in weight loss seems effective, using it without consulting a doctor can be dangerous. Many doctors we approached refused to comment on the drug. One of them, who asked not to be interviewed by name, explained that “like any drug, there are those who are allergic to certain things it contains. I would suggest anyone read it carefully before using it. Overuse of a relatively new drug, without finding out what side effects it can cause “In fact, it can be life-threatening. You should consult specialist doctors and not take a risk just to lose weight.”
“It’s important to clarify: there is no miracle cure that helps with weight loss,” says Dr. Kalmaro. Of a qualified medical staff. ”
“There are quite a few questions that remain unanswered if there is no physician involvement,” Dr. Vardit Kalmero emphasizes. This medicine is not a lollipop“
What might be the problems if the drug is given without a doctor’s involvement?
“For example, what if the patient is taking other medications that may cause a conflict? What about using supplements at the same time? What about teens who are still in growth stages, which hormonal therapy may impair? What about people who suffer from mental problems that may worsen due to use? What happens if the patient “Deciding to stop? What if he has diarrhea because of the drug – should he stop or continue? In short, there are quite a few questions that remain unanswered.”
Like any medicine, osmic has side effects. What does physician involvement mean in this regard?
“It’s important for me to shout this: a drug is neither candy nor nuts. Every drug can have side effects. Osmic is attributed to mood effects, nausea, vomiting, headaches, increased fatigue. Therefore its treatment must be under the guise of medical supervision and accompaniment. It is not a drug that is suitable for widespread use among the general public. ”
How dangerous can the drug be for people with eating disorders?
“Without medical involvement it can lead to malnutrition, and people with eating disorders can lose important nutrients while taking the drug. Especially in such situations it is important that patients be under medical supervision that includes mental support and nutritional support, and in no way use such drugs without the consent of a source. Certified Medical Officer. ”
“Without proper nutrition no medicine will improve”
The black market in osmic may be eliminated once the drug is approved for treatment not only for diabetics. This is the current situation in the United States; Wegovy, which is actually 2.4 mg ozmafic, was approved last June by the U.S. Drug Administration for the treatment of obesity. R. Shaked. Indeed, in studies, Vogobi has shown dramatic results: weight loss of up to 20 percent after a year of treatment. “It’s a relatively new drug, and it’s a matter of regulation and order,” explains Dr. Kalmero. “It’s a formal process, but it’s important. In the end, it’s for the benefit of the public. ”
“Treatment with these drugs is long-term“, Explains Dr. Pazit Shaked. “Studies show that when people stop using them after 20 weeks or more, they regain all the weight over time.”
Kalmaro says that a similar drug is currently in advanced stages of development. “This is a drug that works in exactly the same mechanism, but is given orally. It is currently in a third phase study, but is still waiting to receive all the data before it is approved.”
What do you recommend for those who are interested in treatment today?
“There are clinics that deal with overweight. Part of the process, in addition to medication recommendation, includes psychosocial guidance, follow-up of dietitians and medical assistance. I recommend anyone who wants to lose weight to consult a family doctor, clinical dietitian, or consult such a clinic. With medications or supplements, it is important to consult a clinical pharmacist. “
“Without learning to eat right, no drug will lead to long-term improvement,” says clinical dietitian Prof. Olga Raz. “Even people who have had bariatric surgery gain weight because they have not learned to eat properly. It is better to use Ozamfik for diabetes and Saxanda for weight loss, but accompanied by a change in diet and exercise.”
The reactions of Novo Nordisk, the maker of Ozmific, and the Ministry of Health have not yet been received.
Assisted in the preparation of the article: Michal Halperin