Mounjaro February to April 24 starters - Thread 4

[ObsidianTree]

4th thread!

https://www.mumsnet.com/talk/weight-loss-injections/5207564-mounjaro-february-to-april-24-starters-thread-3?page=40&reply=141722167

I ordered from Oushk on the 16th, they’ve taken the money but the order is still showing as “Processing”. I hope that doesn’t mean there’s a problem. I ordered 2 pens, at lower than normal dose as that was all I could get. I’m ok for now with pens but would like to know what is happening. I’m assuming there’s a backlog and hope to hear something next week

When is your delivery date? They usually review the order and agree to prescribe shortly before that.

Aah @Wonkypictureframe that explains it, I’ve put in delivery for 2nd September as I was ordering in advance and thought they might not approve if it was too close to my previous order.

Am trying to figure out a plan going forwards. I have just finished a 10mg pen today by taking the bonus dose which was actually 15mg as I got every drop out. I now have a 12.5mg pen and two 10mg pens as I have had a small stockpile from ordering every four weeks but using 5 doses from each pen. I was trying to stretch the ordering to every 5-6 weeks but was always nervous about not getting approved now I am at BMI of 24-25.

I am now thinking of using the pens by:
taking 6 x 10mg doses from the 12.5mg pen then
taking 7 x 7.5mg doses from each 10mg pen (I am ok with using a pen for 43 days and will chuck it a week or two early if it doesn’t seem ok to keep using it)

I’d then like to move down to 5mg I think. But the above is 20 doses. How am I going to get a 5mg pen in 20 weeks time? Or should I buy a 5mg pen in a month? My most recently purchased pen is the 12.5mg so how do I explain wanting to buy a 5mg four weeks after that? Maybe I should wait till maintenance plans are a bit clearer and say my stash is from panic ordering this week but that I plan to titrate down?

@Choux
I think pharmacies are going to have to get their heads round having patients who've ordered elsewhere and have a stash which they're titrating down with. No reason why they would refuse coming down in big jumps; titrating down is not strict like titrating up is, especially with cost factored in. The click counting is a bit tricker. Keep your boxes and write a made-up date on them maybe, or say you actually came off/did 1 month on, 1 off to save money but now realise you need to go back on a low dose? I personally wouldn't bother ordering a 5 next month as you'll be in the same place a month after that when you still have a load to use up. Who are you with? If it's a maintenance friendly place, you could have a consult and say you want to try coming off and will they prescribe in say 6 months if you need to go back on. If they agree, you could continue with your plan, then reorder 2.5 , then 5, when you're ready. I agree though - it's complicated.

When I moved over to Oushk for maintenance I had my video consult and said I had a stockpile to use up. They were fine with taking me on with the prescription history I had and then putting me on their flexi plan for future orders. I second the idea of a consult with a maintenance friendly provider.

Thanks Kranky and Wonky. I have been ordering from The Family Chemist for the past 12 months or so as I was a bit wary of Oushk and paying to be on their books when I came off it but wanted the option to take it again in the future. To be honest I just kept buying and using 10mg without a real plan for titrating down. The price increases have made me realise I need to figure it out.

@Choux

This is their entry on monj.co.uk so looks like they're fine for maintenance so might not be necessary to move to oushk or elsewhere (I've been with oushk over a year but will be moving when I've used up my stock and if their prices are poor). I'd be inclined to have a conversation with TFC, see what they say about taking a break (while you continue to use up your stock on the quiet) and their position on re-prescribing. They'll expect you to restart on 2.5 but by then, this might be fine for you anyway if you spend 6 months titrating down - I'm very settled on 2mg.

"The Family Chemist provides Mounjaro and Wegovy maintenance plans for BMIs as low as 19. Additionally, their clinicians closely monitor each patient, ensuring personalized care. They also offer price matching on non-promotional discounts, which helps to reduce costs.

• Lowest joining BMI: 26*
• Lowest maintenance BMI: 21*
• Time limited: No"

I will wait to see what TFCs prices are but they did nothing for customers this last 10 days. They did not limit ordering to existing customers only so sold out in 24 hours and I couldn’t do my usual 10mg order. I ended up getting a more expensive 12.5mg order from elsewhere as it was almost six weeks since my last order.

No comms from them till I mailed them. Then told me they expected stock Thurs / Fri that didn’t come in.

Using another supplier last week and not receiving comms from TFC has opened my mind to switching to a supplier I can actually talk to and get some understanding from.

I think going forwards the number of prescribers offering maintenance will fall as it’s easier and cheaper to focus on the market that is still obese or overweight. Maintenance suppliers will have to up their game to satisfy all GPHC checks and that costs time and money so providers doing maintenance will likely charge a bit more per pen. Am ok with that. Just need to see everyone’s prices and policies next month.

I'm a bit confused on what to do next too. I'm with Ousk, and now have 3 full pens and midway through another. I'm taking 7.5 every ten days. I think this gives me 17 weeks supply.

Once the dust settles, I'll email Oushk as I am not sure if there is a max length between each order for a maintenance customer.

Not sure if I’m allowed to post links to other sites but I’m on Reddit and I’ve just found a thread and it appears they’re changing the pens to contain only 2.4ml of meds :/

https://www.reddit.com/r/mounjaromaintenanceuk/s/Uj6k82a9vi

Fuckers

Genuinely can believe it after this massive price hike. I’ve got enough to last me the next six months thankfully. But I don’t think I can do it alone and I don’t think I can afford the new prices. I’m due surgery next year for skin removal and that’s going to be £300 a month for four years 😣😣😣

@Scalessayeek I have a big stock pile too , boy am I glad I did that. But I wanted to stay on for life as helps my autoimmune condition so much .

@Scalessayeek @Smallsalt

It's just all so grim. It may also end up being counterproductive if people (like me) end up going up from a 2.5 to a 5 pen in response and doing 10 doses from it instead. It'll all be in the maths - this app is really helpful to work it out:

https://www.vrgrowth.co.uk/mounjaro-clicks

Yes I stockpiled up and bought up to 15mg but never went that high in dose. Currently doing my 7.5mg from a 15mg pen. Regretting going down the pens when stockpiling though 😆 May have to try and drop down to 5mg again and see how I get on to make them last longer! With the extra fifth dose I worked out Mounjaro was cheaper than oxempic I think it was 53 a week for epic and 48 for mounjaro but take the extra dose out of the equation and it’s not so good!

Bolt finally let me order a pen but I think they're out of stock, unless they are sneakily saving some for existing customers. I gave it a go anyway and will see what happens.

That link is really useful @KrankyKumquat. If I can get down to doing 5mg doses from a 7.5mg pen costing about £225 that’s £30 per dose and that is what I am paying now for 10mg doses. So while it’s the same price for half the dose and I will need to be doing more of the maintenance effort myself it means I can stay on it.

If the 5th dose is removed the cost increases 25%. But I think there would always have to be a little extra in the pen as the end of the pen is rounded slightly so the plunger can’t get all the way down. It might only be a quarter dose though or maybe even less.

It’s interesting timing this rumour of the 5th dose being removed. People are saying they will use up their stockpiles and cut down on doses to limit how they are affected by the price increases. But the 5th dose rumour is a reason to keep buying pens in the autumn as in the future they might start containing 20% less medication. Sales tactic?

The problem I can see with doing smaller doses from a stronger pen is what pharmacies do about reordering gaps. If they all get very strict about times between orders we could get cut off.

If you buy a pen every 4-5 weeks for a few months you could then discuss with them about trying to come off it so stop ordering for a few months to use up the stockpile. Then tell them it’s not working and you need to go back on a low dose and build back up to 5 or 7,5.

A comment on that Reddit thread:

'I’m going to say that it’s possible it’s just simplification of wording in the leaflet. So that it’s really clear what the mg in ml dose is. Reading the old SmPC I def think a lot of people would be confused what the actual dose should be.

The next section of the new SmPC still talks about discarding excess remaining liquid.

And finally. I don’t see how they are going to only partially fill the pen - it’s designed for 3ml. A partial fill leaves air in the pen that would surely reduce shelf life. The shelf life is listed as 24 months in fridge in same new SmPC.

Also you can’t have an SmPC out that doesn’t apply to medication currently being dispensed - at least that’s my understanding, but only did a little bit of legal regulatory stuff at work, so I may be wrong here. The SmPC is out during July with current pens, so it needs to apply to those.'

Based on this, the extra panic could be unfounded.

I still haven't bought a new pen. I am due to this week. I am just so over it all tbh.

Surely they need a bit of a buffer in the pens and that was the point of it. In theory we could all complain if we don't get a full 60 clicks on our last dose as we haven't got what we purchased.

My order got sent back as it got refused after being delivered to the wrong address. 😫 More admin for me sorting this out now. Yay!

I ordered with MedExpress on 15/8 and I'm still waiting, day 12 of zero communication!

I'm just going to need to come off really. Every time I come off it I am insatiable.
Has anyone overcome this?

My Bolt 10mg order is on the way, clearly their not allowing multiple pens to be ordered has protected their stock!

So far my maintenance has not hit maintaining, I thought I'd been eating quite badly this past week but I still managed to lose a small amount.

@Buffypaws did you come down doses before coming off or just stop? I don't know if that makes a difference to adjusting to the lack of meds or not?