{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:47:02Z","timestamp":1786999622941,"version":"build-2736575974"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["HEPL"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ozempic and related semaglutide drugs represent a popular new strategy to address obesity in the United States, yet uptake of these medications has sparked opposition highlighting concerns about off-label drug use policies, drug safety, supply shortages and cost. Public attitudes towards off-label prescribing by physicians broadly, and towards Ozempic in particular, in light of this opposition are unclear. To better understand public sentiment on this topic, we analysed data from a representative survey of 3,420 US adults conducted from 13 to 22 June 2023. Public attitudes towards off-label prescribing were split, with 46.3 percent supporting physician discretion to prescribe off-label. Importantly though, 58 percent of respondents were at least somewhat concerned about Ozempic supply shortages caused by off-label use and 63 percent were concerned about Ozempic safety in the context of off-label use. Further analysis from an embedded survey experiment shows that rhetoric highlighting safety (but not supply) concerns surrounding off-label Ozempic prescribing is associated with a significant drop in support for off-label use. These results suggest that the introduction of obesity drugs like Ozempic present a pharmaceutical industry-led path for combatting obesity, but rhetoric opposing these drugs could blunt public support and uptake.<\/jats:p>","DOI":"10.1017\/s1744133124000306","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T02:10:35Z","timestamp":1736215835000},"page":"330-343","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["The prevalence and consequences of support for off-label Ozempic prescriptions"],"prefix":"10.1017","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9056-9123","authenticated-orcid":false,"given":"Timothy","family":"Callaghan","sequence":"first","affiliation":[{"name":"Boston University, School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Motta","sequence":"additional","affiliation":[{"name":"Boston University, School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stein","sequence":"additional","affiliation":[{"name":"Boston University, School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirby","family":"Goidel","sequence":"additional","affiliation":[{"name":"Texas A&M University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"S1744133124000306_ref9","unstructured":"Centers for Disease Control and Prevention (CDC) (2022) \u2018Adult obesity facts.\u2019 May 17, 2022. Available at https:\/\/www.cdc.gov\/obesity\/data\/adult.html"},{"key":"S1744133124000306_ref7","unstructured":"Centers for Disease Control and Prevention (2023 a) \u2018Adult obesity prevalence maps.\u2019 September 21, 2023. (2023a). Available at https:\/\/www.cdc.gov\/obesity\/data\/prevalence-maps.html"},{"key":"S1744133124000306_ref28","unstructured":"McPhillips, D (2023) \u2018CNN exclusive: prescriptions for popular diabetes and weight loss drugs soared, but access is limited for some patients.\u2019 CNN. September 27, 2023. Available at https:\/\/www.cnn.com\/2023\/09\/27\/health\/semaglutide-equitable-access"},{"key":"S1744133124000306_ref26","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1606602"},{"key":"S1744133124000306_ref31","unstructured":"Murphy, T (2023) \u2018Supply problems and insurance issues make popular weight-loss drugs hard to get.\u2019 The Associated Press. September 16, 2023. Available at https:\/\/apnews.com\/article\/wegovy-ozempic-mounjaro-shortage-insurance-64014bc2887a518b33c597b2bf936e37"},{"key":"S1744133124000306_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2018.09.005"},{"key":"S1744133124000306_ref24","doi-asserted-by":"publisher","DOI":"10.1038\/s41541-021-00335-2"},{"key":"S1744133124000306_ref13","unstructured":"Constantino, A (2023) \u2018EU expands Wegovy, Ozempic probe over suicide risks to include other weight loss, diabetes drugs.\u2019 CNBC. July 11, 2023. Available at https:\/\/www.cnbc.com\/2023\/07\/11\/weight-loss-drugs-eu-expands-ozempic-probe-over-suicide-risks.html"},{"key":"S1744133124000306_ref19","unstructured":"Gilbert, D (2023) \u2018Insurers clamping down on doctors who prescribe Ozempic for weight loss.\u2019 The Washington Post. June 12, 2023. Available at https:\/\/www.yahoo.com\/lifestyle\/insurers-clamping-down-doctors-prescribe-024823824.html"},{"key":"S1744133124000306_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfad037"},{"key":"S1744133124000306_ref30","doi-asserted-by":"publisher","DOI":"10.1215\/03616878-10852592"},{"key":"S1744133124000306_ref8","volume-title":"Behavioral Risk Factor Surveillance System Survey Data","year":"2023"},{"key":"S1744133124000306_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2023.104860"},{"key":"S1744133124000306_ref18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1614362"},{"key":"S1744133124000306_ref2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000973"},{"key":"S1744133124000306_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61744-X"},{"key":"S1744133124000306_ref36","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfr053"},{"key":"S1744133124000306_ref37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.19574"},{"key":"S1744133124000306_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.9.1021"},{"key":"S1744133124000306_ref27","unstructured":"Lovelace, B Jr. (2023) \u2018Popular weight loss drugs linked to rare but severe stomach problems, study finds.\u2019 NBC News. October 5, 2023. Available at https:\/\/www.nbcnews.com\/health\/health-news\/ozempic-wegovy-linked-severe-medical-conditions-stomach-problems-study-rcna118823"},{"key":"S1744133124000306_ref5","first-page":"1","article-title":"PCDS consensus statement: a strategy for managing the supply shortage of the GLP-1 RAs Ozempic and Trulicity","volume":"24","author":"Beba","year":"2022","journal-title":"Diabetes and Primary Care"},{"key":"S1744133124000306_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2013.01.001"},{"key":"S1744133124000306_ref29","unstructured":"Merelli, A (2023) \u2018Insurance coverage for Ozempic shows the complexity of obesity treatment.\u2019 Quartz via Yahoo. May 29, 2023. Available at https:\/\/finance.yahoo.com\/news\/insurance-coverage-ozempic-shows-complexity-120000029.html"},{"key":"S1744133124000306_ref11","unstructured":"Choi, A and Vu, H (2023) \u2018Ozempic prescriptions can be easy to get online. Its popularity for weight loss is hurting those who need it most.\u2019 CNN. March 17, 2023. Available at https:\/\/www.cnn.com\/2023\/03\/17\/health\/ozempic-shortage-tiktok-telehealth\/index.html"},{"key":"S1744133124000306_ref38","doi-asserted-by":"publisher","DOI":"10.1177\/10659129231182375"},{"key":"S1744133124000306_ref35","doi-asserted-by":"publisher","DOI":"10.1038\/s41587-023-01818-4"},{"key":"S1744133124000306_ref41","unstructured":"US Food & Drug Administration (2024) \u2018FDA approves first treatment to reduce risk of serious heart problems specifically in adults with obesity or overweight.\u2019 FDA. March 8, 2024. Available at https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or"},{"key":"S1744133124000306_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/2053168018822174"},{"key":"S1744133124000306_ref6","doi-asserted-by":"publisher","DOI":"10.3386\/w30440"},{"key":"S1744133124000306_ref39","first-page":"1","article-title":"A note on increases in inattentive online survey-takers since 2020","volume":"2","author":"Ternovski","year":"2022","journal-title":"Journal of Quantitative Description: Digital Media"},{"key":"S1744133124000306_ref40","unstructured":"Tirrell, M (2023) \u2018Makers of Ozempic, Mounjaro race to ramp up supply amid skyrocketing demand for drugs for weight loss.\u2019 CNN. October 6th, 2023. Available at https:\/\/www.cnn.com\/2023\/10\/06\/health\/ozempic-mounjaro-supply\/index.html"},{"key":"S1744133124000306_ref16","first-page":"822","article-title":"Salience, myopia, and complex dynamic incentives: evidence from Medicare Part D","volume":"87","author":"Dalton","year":"2020","journal-title":"The Review of Economic Studies"},{"key":"S1744133124000306_ref20","doi-asserted-by":"publisher","DOI":"10.1177\/0002716209351526"},{"key":"S1744133124000306_ref32","doi-asserted-by":"publisher","DOI":"10.1017\/XPS.2021.17"},{"key":"S1744133124000306_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2010.00825.x"},{"key":"S1744133124000306_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00879.x"},{"key":"S1744133124000306_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/1065912916658551"},{"key":"S1744133124000306_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfl020"},{"key":"S1744133124000306_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjad211"},{"key":"S1744133124000306_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61745-1"},{"key":"S1744133124000306_ref4","first-page":"90","article-title":"Semaglutide (Wegovy) for the treatment of obesity","volume":"107","author":"Bald","year":"2023","journal-title":"American Family Physician"}],"container-title":["Health Economics, Policy and Law"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1744133124000306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T09:33:09Z","timestamp":1761816789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1744133124000306\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["S1744133124000306"],"URL":"https:\/\/doi.org\/10.1017\/s1744133124000306","relation":{},"ISSN":["1744-1331","1744-134X"],"issn-type":[{"value":"1744-1331","type":"print"},{"value":"1744-134X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}