Regulators looking to cut off maintenance below 25 BMI

[Bigfatsunandclouds]

Oushk have said that they are currently trying to fight with regulators to stop people being cut off from MJ at 25 BMI.

Apparently regulators don't like prescribing below that and that basically means unless you continue to remain at 25 or above you won't be able to be prescribed even for maintenance.

This is worrying as many see this as a lifetime medication after years of obesity but at least to maintain at a lower BMI for a little while to ensure the weight stays off. This seems like utter madness - this is surely going to lead to yo yo use of the meds which seems counterintuitive.

BMI in a lot of cases is a stupid archaic measurement anyway.

I had a consultation with Oushk today. My bmi is 23.5. I want to move to them for maintenance.

they have accepted me and provided three months worth of discount codes. I weighted myself during the consultation process I verify my weight.

Is it still the case that you pay a monthly retainer with Oushk?

I think that’s only for one of the plans. I am going on the conti plan - so continuing on 5mg. I will get a 15% discount on each one but don’t think I have to pay a subscription.

haven’t ordered yet though

Every time I see Livewell being oh so subtly mentioned, I think it’s that banned poster who thinks she’s being really subtle but err .. isn’t

That sounds as though you’re accusing someone on this thread of being a pbp.

@Mounjour not at all. Merely stating that every time I see the word, I think of that poster being all non subtle

are you feeling sensitive? 🤣

Not me. I've been here for years, although I've had some name changes...

That was such a strange one and yes have the same thoughts when I see their pharmacy name. Whether she worked for Livewell or not she did their business no favours on MN! They may be a very good pharmacy, but I just have that slight apprehension about them now and there are enough alternatives that I don't need to take the risk.

are you feeling sensitive? 🤣

There was nothing particularly sensitive in my post .

@WeAllHaveWings what do you feel are the risks? I’m pondering whether to stick with Oushk or jump ship.

I think I'm going to stick with Oushk. I suspect a lot of pharmacies will have similar inspection challenges and they seem incredibly committed to ensuring my long term health rather than abandoning me once I hit a certain bmi. Hopefully I won't regret it or I'll be back where I started in a few years!

Can anyone with a bit more knowledge than me explain what the new stricter regulations involve or are going to involve? Not just Oushk but generally. Are there plans to cut you off once you reach a certain bmi? I’ve just ordered my second pen from Asda (been on 2.5 for 3 and a half wks and going up to 5) started with a bmi of 30 and it’s now down to 27. I’m hoping to stay on it until my bmi is down to around 21, which I’m guessing will be in around 6 months time. Will I still be able to get it for the next 6 months even after my bmi goes below 25?

It is a tricky one @Mounjour I am obviously with Oushk too at the moment.

My biggest (perceived as I haven't researched them thoroughly) concern with Livewell is they are one of the very new (to online WLI selling) kids on the block. Yes, they might (going by that MN poster!) give great, personalised service now, but they still have to go through the growth stage where they will need more prescribers, staff, more efficient processes to handle larger volume etc.

Oushk is far from perfect and their focus on social media and their "faithful" can be irritating, sometime entertaining, but they are further along navigating the challenges of that journey.

Then add in how Oushk are navigating the guidelines, they are being (perhaps naively) transparent in what they see as the GPhC issues and how they think they will handle them to make the GPhC happy. Remember the GPhC doesn't say to pharmacies clear rules like "you cannot prescribe below BMI 21", they give pharmacies a load of wooly guidelines about patient safety etc and pharmacies need to interpret them.

Oushk sharing one of the thing they are "thinking" about is not taking on new maintenance customers below BMI 25.5 might mean if (once I get there) there is no ability to move back if moving to a new provider (that hasn't been through a recent inspection yet) and it doesn't work out.

Anyone near maintenance, I think needs to think carefully about how they will play their hand as it may cut of future options, for now I personally think I am going to stick, keep my eyes open and see how this plays out over the next month or so of the enforcement notice. I could try another maintenance provider, but at the stage I am at, getting closing to maintenance I am thinking I might be better with the devil I know (plus I have a pen on hand and another preordered for the end of the month).

Good luck with your own decision!

Oushk is the only pharmacy to actually get an enforcement notice which is far more serious than anything oother providers have received and of course they'd like us to believe its about their maintenance prescribing however if you read the report you'll see they had a number of serious failings!

@MJLife
The full report isn't published yet - all that's available is the enforcement notice. Granted this covers a number of areas for improvement but there's no way of knowing from this the context or the extent of the issues. All of the items listed might relate to maintenance patients specifically or to all patients, we just don't know. But given that the focus on the changes being brought in immediately is almost entirely related to the safe prescribing and monitoring of maintenance patients, I'm assuming this is where the main issues of concern lay. And I would dispute that other pharmacies wouldn't have faced similar challenges if judged to the same standards - how many pharmacies have completed independent weight, waist and height verification for 100% of all their current customers? Or haven't had a single complaint about the delivery of a warm pen? Or have a programme of diet, exercise and lifestyle education classes which all patients have to attend? Or only accept transfers in after proof of the first prescription rather than the last?

I think it's pretty weird how so many other pharmacies' MJ users are responding to the inspection on SM. Not once have i seen any concern expressed for Oushk patients or support for them, just unseemly relish about a pharmacy to thousands getting their comeuppence or something. It's not a bloody competition.

@purpledaze24 if you read the enforcement notice there is absolutely nothing about maintenance at all. The GPhC are not responsible for that. It’s the MHRA that decide how the drug can be prescribed. The GPhC are only there to assess the pharmacies ability to prescribe safely.

So, no, there are no plans to cut off access to mounjaro at a higher bmi. At least, not that anyone knows of and certainly not something Oushk have personal access to!

I did somewhat cynically ask a few days ago if the GPhC had ‘really’ got plans to reduce the bmi for prescribing or whether it was a deflection attempt from the details in the enforcement notice of lack of monitoring of storage temperatures etc etc. Looks like my inner cynic may have been correct!

Thanks @WeAllHaveWings . We are very much of a like mind. The only difference is I’m a few months from maintenance, so wondering whether to get a second pharmacy on board at this stage to give me options.

How stupid of them. I'd just lie to carry on if required to get to BMI 23. Much better that and have some wriggle room than risk putting the weight back on again.

@spoonbillstretford That is one of the significant areas/concerns for patients safety the GPhC is asking Oushk, or any online pharmacy they inspect to resolve, patients lying to obtain the medication.

Over time you will find more pharmacies adding more robust checks before prescribing. These might include independent verification of height from NHS records etc and/or video calls showing weight or physique, especially if the patients whole weight loss journey history has not been with the same provider.

I don't think the problem is prescribing at BMI 23 the problem is pharmacies ensuring they have documented evidence they have verified that the patients BMI is actually 23 (or whatever).

@IReallyNeedThisToWork I think you’re onto something there. I can’t find anything which specifically targets / pinpoints MJ users who are on maintenance yet for some reason it’s all over the group and Oushk have fed into that too but why? Where is the report from a governing body specifically stating ‘ we are now turning our attentions to maintenance users?’ … Doesn’t seem to exist.

@IReallyNeedThisToWork @WeAllHaveWings you both sound quite clued up on all this can you explain it to me simply 😂

I'm not a oushk customer yet but was thinking of switching to either them or pharmolous when the time for maintenance comes.

I joined the oushk FB group to try and make sense of it all but it's so busy and I started watching the live but I'm more confused.

So they've failed in many areas is that right and have until end of the month to sort it?

What's all the stuff about not prescribing below 25 about (not that I'm anywhere near that yet!)

They’ve failed in several areas and been served an improvement notice. Have a read.

Out of nowhere, Hira has announced that she is battling ‘the regulators’ about their plans to prevent prescribing for maintenance below 25bmi. Nobody knows where this has come from and I am cynical enough to think it is a distraction attempt to keep customers’ focus on Oushk’s heroic ‘David and Goliath’ battle to stand up for the needs of their patients rather than the massive admin cock ups the pharmacy have been caught out on.

I would email my provider and ask if they know what’s going on but really don’t want to waste their time!

It just all sounds a bit stressful and dramatic - makes me want to choose somewhere else (rightly or wrongly)

On the packaging issue- from the enforcement notice, this reminds me, I heard they had started only packing with one icepack is that correct, as most use two.

The pharmacy must provide assurance that it regularly tests the effectiveness of the packaging used to supply injections which require cold storage, to ensure they remain at the required temperature during delivery.

I know I keep repeating this- but it doesn’t make sense to use bmi of 25 as a cut off when some ethnicities need to be under 23. You’d think oushk would have pointed this out???

Plenty of options for maintenance.