ausdoc. com. au 18 JULY 2025

Novo Nordisk says it does not support off-label use.

Jamie Thannoo UNDER-18s are receiving scripts for the blockbuster semaglutide drug Ozempic despite it not being TGA approved for children or adolescents.

The Department of Health, Disability and Ageing says 625 prescribers wrote 2832 PBS scripts for Ozempic for under- 18s between 2020 / 21 and 2023 / 24.

Some 1514 scripts were written in 2023 / 24.

Lack of data means the precise clinical indications for which the drug is being used are largely unknown.

The drug is only PBS listed for type 2 diabetes, which is rare in children, with only 320 Australians aged under 15 having the condition in 2024.

Paediatric clinical pharmacologist Professor Madlen Gazarian said, if children were being prescribed Ozempic off label for obesity, it should only occur with approval from a paediatric multidisciplinary clinic specialising in weight management.

“ I would not be comfortable with off-label use being initiated for a child in a general practice setting,” said Professor Gazarian, from UNSW Sydney.

“ There might be effects on growth and development not seen in adults.

We need to balance that risk.”

Professor Gazarian said pharmacologists had repeatedly called for a national system to collect realworld data on off-label medicine use.

If children were receiving Ozempic, the data could be used to study safety and efficacy, she said.

This could also show how many were prescribed Ozempic for weight

The drug is only PBS listed for type 2 diabetes.

Professor Maria Craig.

management compared with type 2 diabetes.

“ When widespread non-evidence-based off-label use becomes established, it removes the incentive to conduct the needed research,” she said.

“ We have seen that happen over and over again with other medicines.” For example, prescribing quetiapine for insomnia had become widespread

Health Department data

Financial year

PBS Ozempic scripts for children

2020 / 21 114 2021 / 22 471 2022 / 23 733 2023 / 24 1514

despite being off label, as had baclofen for alcohol use disorder.

Professor Maria Craig, a paediatric endocrinologist and childhood diabetes researcher, said she did not believe there was a significant safety risk with children taking Ozempic.

Based at The Children’ s Hospital at Westmead, Sydney, she said clinical trials of other forms of semaglutide in children had shown similar safety outcomes as those seen with adults.

She stressed that international guidelines also recommended GLP-1 receptor agonists for adolescents with type 2 diabetes.

A spokesperson for Novo Nordisk told Australian Doctor it did not support or promote off-label use of Ozempic.

It stressed it was committed to working with regulators and the medical community“ to ensure that any future use in adolescents is based on robust clinical evidence and aligned with public health needs”.

highest-paying job was a $ 500-an-hour, five-hour anaesthetist gig.

Dr Sisk told Australian Doctor that rural hospitals valued GP locums.

“ The GP skill set in an ED is a phenomenal crossover,” he said.

The data, mainly for day shifts in rural areas, included job orders from 10 % of all Australian hospitals.

“ In rural EDs, you see all these cases where people come in because they could not get in to see their GP for things that should be a GP presentation.”

Dr Louis Sisk.

FROM PAGE 1

There was mixed consensus regarding chemotherapy. Dr Gujadhur’ s gynae-oncologist advocated for a conservative approach.

“ In the end, I opted for a non-invasive, strict surveillance program over 10 years.”

Now in her third year of remission, Dr Gujadhur agrees with the axiom that doctors are often bad patients.

“ I kept thinking about work and what would happen to my career.“ All the emotion hit me, and

I went through a short period of depression. I was scared at first of seeking help, as I knew mental health issues among health professionals could be a sensitive topic.

“ When I took time off for scans or blood tests, I didn’ t feel comfortable telling my colleagues about it.

“ You are still processing it yourself, yet you have to deal with someone else’ s reaction or the look they are going to give you as if you are dying.“ That made me feel sicker.” Writing helped her cope, which ultimately led to her advocacy work with the Ovarian Cancer Research Foundation, which raises funds for researchers.

“ One day I thought,‘ I am in a strong position as a doctor and patient, and I could use my story for the better.’ So I contacted the foundation, as I was interested in the research aspect.

“ I remember the day we published my story on the foundation’ s website; I was so scared of my friends or people at work reading it. But I am more comfortable now.”

‘ I did not feel comfortable telling my colleagues.’

She is hopeful that more research funding into ovarian cancer can improve diagnosis of“ the silent killer”.

“ Although I would say it is more of an ignored killer because, in medical school, we are barely taught about it.

“ We know the four different types and basic things like tumour markers, but there is not much emphasis on the lack of screening tests or the non-specific symptoms.

“ It can easily be misdiagnosed as irritable bowel syndrome or a benign condition.”

Her experience as a patient has also shaped her intentions in medicine.

“ Having received a cancer diagnosis, I know the things I did not like or that I wish no-one had asked me.

“ It also taught me about having end-of-life conversations.”

She hated people trying to stay positive, telling her,“ You’ ve got this, you’ ll be okay.”“ It drove me insane,” she says.“ Working in oncology, you just need to listen to your patients; all they want is an ear.

“ Sometimes, I just needed someone to be there, listen, let me cry and pick myself up again.”

There is no simple ending to her story. Life is complicated.

This year, she received another diagnosis: a neuroendocrine tumour.“ It was exactly three years after my initial diagnosis,” she says.

“ It has been hard on me and my parents, who are overseas. Dad came over again, but they felt helpless.”

The prognosis is positive. Dr Gujadhur is now on an additional five-year surveillance program with a general surgeon.

“ The emotional toll of the past three years, and the more recent challenges, has got to me,” she says.

“ But with the help of loved ones and a supportive GP, I faced that I needed help.”