Evaluating community pharmacists’ dispensing and counseling practices of semaglutide for weight loss in the United Arab Emirates: A simulated patient study
Main Article Content
Keywords
Ozempic , Pharmacist, simulated patient, prescription , dispensing , patient counseling, semaglutide
Abstract
Background: The rising global prevalence of obesity has led to increased demand for medications such as Semaglutide (Ozempic®), which is approved for the treatment of type 2 diabetes. However, its off-label use for weight loss has raised international concerns regarding misuse, patient safety, and pharmacist accountability. Objectives: This study aimed to assess whether community pharmacists in the UAE dispense Ozempic® without a valid prescription and to evaluate the quality and comprehensiveness of pharmacists’ screening and counseling regarding Ozempic®. Methods: A cross-sectional study was conducted using the simulated patient (SP) methodology. A trained SP visited 153 randomly selected community pharmacies across Dubai and the Northern Emirates and requested Ozempic® without a prescription for weight loss. Data was collected using a structured checklist covering prescription requirements, screening practices, and counseling quality. Results: Of the 153 pharmacies visited, only a minority (26.8%) requested a prescription for Ozempic® before dispensing the medication. Chain pharmacies (35.4%) and female pharmacists (38.6%) were significantly more likely to request a prescription (p = 0.011 and p = 0.004). Additionally, when comparing the total percentage of pharmacists willing to dispense the medication without a prescription to a hypothetical benchmark of 50%, the difference was statistically significant (p<0.001). Screening practices were minimal, with only 3–30% of pharmacists inquiring about basic patient information. Counselling quality was generally low, with 27% of visits receiving no counselling. Male pharmacists had significantly higher counselling scores than female pharmacists (p = 0.024). Time spent in the pharmacy was significantly correlated with better counselling (p < 0.001). In 20.3% of visits, alternatives, such as Tirzepatide or herbal weight loss products, were suggested. Conclusion: The study revealed significant gaps in prescription compliance and patient counseling among UAE community pharmacists when dispensing Ozempic®. These findings reflect broader global concerns about off-label medication use and the critical role of pharmacists in ensuring safe access to high-demand therapies.
References
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23. Mobark DM, Al-Tabakha MM, Hasan S. Assessing hormonal contraceptive dispensing and counseling provided by community pharmacists in the United Arab Emirates: A simulated patient study. Pharm Pract (Granada). 2019;17(2):1465. doi:10.18549/PharmPract.2019.2.1465
24. Al-Tannir M, Altannir Y, Altannir M, AlFayyad I. Community pharmacy sales of non-prescribed antibiotics in Riyadh, Saudi Arabia: a simulated patient study. Int J Clin Pharm. 2020;42(2):341-346. doi:10.1007/s11096-020-01033-0
25. Weiner SJ, Schwartz A. Directly observed care: Can unannounced standardized patients address a gap in performance measurement? J Gen Intern Med. 2014;29(8):1183-1187. doi:10.1007/s11606-014-2860-7
26. Rhodes KV, Miller FG. Simulated patient studies: An ethical analysis. Milbank Q. 2012;90(4):706-724. doi:10.1111/j.1468-0009.2012.00680.x
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33. Singh S, Chang HY, Richards TM, Weiner JP, Clark JM, Segal JB. Glucagon-like peptide-1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study. JAMA Intern Med. 2013;173(7):534-539. doi:10.1001/jamainternmed.2013.2720
34. He L, Wang J, Ping F, Yang N, Huang J, Li Y, Xu L, Li W, Zhang H. Association of glucagon-like peptide-1 receptor agonist use with risk of gallbladder and biliary diseases: A systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med. 2022;182(5):513-519. doi:10.1001/jamainternmed.2022.0338
35. Jairoun AA, Al-Himyari SS, Shahwan M, Al Ani M, Habeb M, Jairoun M, Zyoud SH, Alkhanani MF, Alhasani RH, Hakami AY, Ainousah BA, Alshehri FS, Alorfi NM, Suliman A. Community pharmacists’ perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis. Front Pharmacol. 2023;14:1237717. doi:10.3389/fphar.2023.1237717
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37. Ibrahim MI, Palaian S, Al-Sulaiti F, El-Shami S. Evaluating community pharmacy practice in Qatar using simulated patient method: acute gastroenteritis management. Pharm Pract (Granada). 2016;14(4):800. doi:10.18549/PharmPract.2016.04.800
38. Hasan S, Al Oum L, Hassan NA. A simulated patient study to evaluate community pharmacist assessment, management and advice giving to patients with asthma. J Pharm Policy Pract. 2021;14(1):8. doi:10.1186/s40545-020-00294-4
39. Hamoudi NM, Shirwaikar AA, Ali HS, Ayoubi EIA. Pharmaceutical consultation in UAE community pharmacies. Indian J Pharm Sci. 2011;73(4):404-408. doi:10.4103/0250-474X.95621
40. Rayes IK, Hassali MA, Abduelkarem AR. Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach. Pharm Pract (Granada). 2015;13(2):506. doi:10.18549/pharmpract.2015.02.506
41. Nathan AD, Shankar PR, Sreeramareddy CT. Community pharmacists’ counseling practices and patient experiences about topical corticosteroids – an online survey in the Klang Valley, Malaysia. BMC Prim Care. 2022;23(1):263. doi:10.1186/s12875-022-01871-z
42. Surur AS, Getachew E, Teressa E, Hailemeskel B, Getaw NS, Erku DA. Self-reported and actual involvement of community pharmacists in patient counseling: a cross-sectional and simulated patient study in Gondar, Ethiopia. Pharm Pract (Granada). 2017;15(1):890. doi:10.18549/PharmPract.2017.01.890
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2. Ruze R, Liu T, Zou X, Song J, Chen Y, Xu R, Yin X, Xu Q. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol. 2023;14:1161521. doi:10.3389/fendo.2023.1161521
3. Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB; ESC Scientific Document Group. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J. 2024;45(38):4063-4098. doi:10.1093/eurheartj/ehae508
4. Stephenson J, Smith CM, Kearns B, Haywood A, Bissell P. The association between obesity and quality of life: a retrospective analysis of a large-scale population-based cohort study. BMC Public Health. 2021;21(1):1990. doi:10.1186/s12889-021-12009-8
5. Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP; American Heart Association Council on Lifestyle and Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Stroke Council. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021;143(21):e984-e1010. doi:10.1161/CIR.0000000000000973
6. American Diabetes Association Professional Practice Committee. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S145-S157. doi:10.2337/dc24-S008
7. Gudzune KA, Kushner RF. Medications for obesity: A review. JAMA. 2024;332(7):571-584. doi:10.1001/jama.2024.10816
8. U.S. Food and Drug Administration. Ozempic (semaglutide) prescribing information [Internet]. 2025 [cited 2025 May 28]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf
9. Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Netw Open. 2022;5(9):e2231982. doi:10.1001/jamanetworkopen.2022.31982
10. Tan HC, Dampil OA, Marquez MM. Efficacy and safety of semaglutide for weight loss in obesity without diabetes: A systematic review and meta-analysis. J ASEAN Fed Endocr Soc. 2022;37(2):65-72. doi:10.15605/jafes.037.02.14
11. Han SH, Safeek R, Ockerman K, Trieu N, Mars P, Klenke A, Furnas H, Sorice-Virk S. Public interest in the off-label use of glucagon-like peptide 1 agonists (Ozempic) for cosmetic weight loss: A Google Trends analysis. Aesthet Surg J. 2024;44(1):60-67. doi:10.1093/asj/sjad211
12. Farahvash A, Lee MC, Jain R, Jaakkimainen L. Pattern of semaglutide prescription in a real-world Canadian patient cohort. Prim Care Diabetes. 2025;19(5):512-516. doi:10.1016/j.pcd.2025.06.006
13. Kushner RF, Ryan DH, Deanfield J, Kokkinos A, Cercato C, Wilding J, Burguera B, Wu CC, Craciun AE, Pall D, Hramiak I, Hjelmesæth J, Harder-Lauridsen NM, Weimers P, Jeppesen OK, Kallenbach K, Lincoff AM, Lingvay I. Safety profile of semaglutide versus placebo in the SELECT study: a randomized controlled trial. Obesity (Silver Spring). 2025;33(3):452-462. doi:10.1002/oby.24222
14. Bezin J, Gouverneur A, Pénichon M, Mathieu C, Garrel R, Hillaire-Buys D, Pariente A, Faillie JL. GLP-1 receptor agonists and the risk of thyroid cancer. Diabetes Care. 2023;46(2):384-390. doi:10.2337/dc22-1148
15. Shu Y, He X, Wu P, Liu Y, Ding Y, Zhang Q. Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system. Front Public Health. 2022;10:996179. doi:10.3389/fpubh.2022.996179
16. World Obesity Federation. United Arab Emirates: Obesity in numbers 2023 [Internet]. 2024 [cited 2025 Jun 28]. Available from: https://www.worldobesity.org/resources/resource-library/united-arab-emirates-obesity-in-numbers
17. Ng SW, Zaghloul S, Ali H, Harrison G, Yeatts K, El M, Popkin BM. Nutrition transition in the United Arab Emirates (UAE). Eur J Clin Nutr. 2011;65(12):1328-1337. doi:10.1038/ejcn.2011.135
18. U.S. Food and Drug Administration. FDA warns consumers not to use counterfeit Ozempic (semaglutide) found in U.S. drug supply chain [Internet]. 2025 [cited 2025 Jun 26]. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-consumers-not-use-counterfeit-ozempic-semaglutide-found-us-drug-supply-chain
19. U.S. Food and Drug Administration. FDA approves new drug treatment for chronic weight management, first since 2014 [Internet]. 2021 [cited 2025 Apr 26]. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management
20. Reuters. Weight-loss drug Wegovy: How much does it cost and where is it sold? [Internet]. 2024 [cited 2025 Mar 13]. Available from: https://www.reuters.com/business/healthcare-pharmaceuticals/launches-novo-nordisks-weight-loss-drug-wegovy-2023-09-04
21. Webster N. Ozempic maker urges UAE users to switch to Wegovy for weight loss [Internet]. 2024 [cited 2025 Mar 13]. Available from: https://www.thenationalnews.com/health/2024/05/22/ozempic-maker-urges-uae-users-to-switch-to-wegovy-for-weight-loss
22. Berning P, Adhikari R, Schroer AE, Jelwan YA, Razavi AC, Blaha MJ, Dzaye O. Longitudinal analysis of obesity drug use and public awareness. JAMA Netw Open. 2025;8(1):e2457232. doi:10.1001/jamanetworkopen.2024.57232
23. Mobark DM, Al-Tabakha MM, Hasan S. Assessing hormonal contraceptive dispensing and counseling provided by community pharmacists in the United Arab Emirates: A simulated patient study. Pharm Pract (Granada). 2019;17(2):1465. doi:10.18549/PharmPract.2019.2.1465
24. Al-Tannir M, Altannir Y, Altannir M, AlFayyad I. Community pharmacy sales of non-prescribed antibiotics in Riyadh, Saudi Arabia: a simulated patient study. Int J Clin Pharm. 2020;42(2):341-346. doi:10.1007/s11096-020-01033-0
25. Weiner SJ, Schwartz A. Directly observed care: Can unannounced standardized patients address a gap in performance measurement? J Gen Intern Med. 2014;29(8):1183-1187. doi:10.1007/s11606-014-2860-7
26. Rhodes KV, Miller FG. Simulated patient studies: An ethical analysis. Milbank Q. 2012;90(4):706-724. doi:10.1111/j.1468-0009.2012.00680.x
27. Yellow Pages UAE. Pharmacies UAE [Internet]. 2025 [cited 2024 Nov 5]. Available from: https://www.yellowpages-uae.com
28. Australian Bureau of Statistics. Sample size calculator [Internet]. 2024 [cited 2024 Nov 5]. Available from: https://www.abs.gov.au/websitedbs/D3310114.nsf/home/Sample+Size+Calculator
29. Do TA, Quan PB, Le TTB, Du TT, Duong STT, Nguyen KTT, Nguyen KN, Nguyen HQ. Antibiotic dispensing without a prescription across community pharmacies: A simulated patient study. Explor Res Clin Soc Pharm. 2025;18:100590. doi:10.1016/j.rcsop.2025.100590
30. Li J, Zhou P, Wang J, Li H, Xu H, Meng Y, Ye F, Tan Y, Gong Y, Yin X. Worldwide dispensing of non-prescription antibiotics in community pharmacies and associated factors: a mixed-methods systematic review. Lancet Infect Dis. 2023;23(9):e361-e370. doi:10.1016/S1473-3099(23)00130-5
31. Al-Mohamadi A, Badr A, Bin Mahfouz L, Samargandi D, Al Ahdal A. Dispensing medications without prescription at Saudi community pharmacy: extent and perception. Saudi Pharm J. 2013;21(1):13-18. doi:10.1016/j.jsps.2011.11.003
32. Kommu S, Whitfield P. Semaglutide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jun 23]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK603723/
33. Singh S, Chang HY, Richards TM, Weiner JP, Clark JM, Segal JB. Glucagon-like peptide-1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study. JAMA Intern Med. 2013;173(7):534-539. doi:10.1001/jamainternmed.2013.2720
34. He L, Wang J, Ping F, Yang N, Huang J, Li Y, Xu L, Li W, Zhang H. Association of glucagon-like peptide-1 receptor agonist use with risk of gallbladder and biliary diseases: A systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med. 2022;182(5):513-519. doi:10.1001/jamainternmed.2022.0338
35. Jairoun AA, Al-Himyari SS, Shahwan M, Al Ani M, Habeb M, Jairoun M, Zyoud SH, Alkhanani MF, Alhasani RH, Hakami AY, Ainousah BA, Alshehri FS, Alorfi NM, Suliman A. Community pharmacists’ perspectives on cardiovascular disease pharmaceutical care in the United Arab Emirates: a questionnaire survey-based analysis. Front Pharmacol. 2023;14:1237717. doi:10.3389/fphar.2023.1237717
36. Alastalo N, Siitonen P, Jyrkkä J, Hämeen-Anttila K. The quality of non-prescription medicine counselling in Finnish pharmacies – a simulated patient study. Explor Res Clin Soc Pharm. 2023;11:100304. doi:10.1016/j.rcsop.2023.100304
37. Ibrahim MI, Palaian S, Al-Sulaiti F, El-Shami S. Evaluating community pharmacy practice in Qatar using simulated patient method: acute gastroenteritis management. Pharm Pract (Granada). 2016;14(4):800. doi:10.18549/PharmPract.2016.04.800
38. Hasan S, Al Oum L, Hassan NA. A simulated patient study to evaluate community pharmacist assessment, management and advice giving to patients with asthma. J Pharm Policy Pract. 2021;14(1):8. doi:10.1186/s40545-020-00294-4
39. Hamoudi NM, Shirwaikar AA, Ali HS, Ayoubi EIA. Pharmaceutical consultation in UAE community pharmacies. Indian J Pharm Sci. 2011;73(4):404-408. doi:10.4103/0250-474X.95621
40. Rayes IK, Hassali MA, Abduelkarem AR. Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach. Pharm Pract (Granada). 2015;13(2):506. doi:10.18549/pharmpract.2015.02.506
41. Nathan AD, Shankar PR, Sreeramareddy CT. Community pharmacists’ counseling practices and patient experiences about topical corticosteroids – an online survey in the Klang Valley, Malaysia. BMC Prim Care. 2022;23(1):263. doi:10.1186/s12875-022-01871-z
42. Surur AS, Getachew E, Teressa E, Hailemeskel B, Getaw NS, Erku DA. Self-reported and actual involvement of community pharmacists in patient counseling: a cross-sectional and simulated patient study in Gondar, Ethiopia. Pharm Pract (Granada). 2017;15(1):890. doi:10.18549/PharmPract.2017.01.890
43. United Arab Emirates. Federal Law No. (8) of 2019 on medical products, pharmacy profession and pharmaceutical establishments [Internet]. 2019 [cited 2025 May 5]. Available from: https://uaelegislation.gov.ae/en/legislations/1426/download
44. U.S. Food and Drug Administration. WEGOVY (semaglutide) injection, for subcutaneous use [Internet]. 2023 [cited 2025 May 5]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/215256s007lbl.pdf
45. Marfo AF, Owusu-Daaku FT, Kyerewaa-Akromah E. Patient knowledge of medicines dispensed from Ghanaian community pharmacies. Pharm Pract (Granada). 2013;11(2):66-70. doi:10.4321/s1886-36552013000200002
46. Al Aqeel S, Abanmy N, AlShaya H, Almeshari A. Interventions for improving pharmacist-led patient counselling in the community setting: a systematic review. Syst Rev. 2018;7(1):71. doi:10.1186/s13643-018-0727-4
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Evaluating community pharmacists’ dispensing and counseling practices of semaglutide for weight loss in the United Arab Emirates: A simulated patient study. Pharm Pract (Granada) [Internet]. 2026 Mar. 10 [cited 2026 Mar. 26];24(1):1-10. Available from: https://pharmacypractice.org/index.php/pp/article/view/3476
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How to Cite
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Evaluating community pharmacists’ dispensing and counseling practices of semaglutide for weight loss in the United Arab Emirates: A simulated patient study. Pharm Pract (Granada) [Internet]. 2026 Mar. 10 [cited 2026 Mar. 26];24(1):1-10. Available from: https://pharmacypractice.org/index.php/pp/article/view/3476