Sweden's skyrocketing sales of new weight-loss medications have hit 230 million SEK for two brands in a single month. Behind this pharmaceutical boom, a dangerous trend is emerging in pharmacies across the country. Customers are asking staff how to self-adjust their expensive injection doses to make the treatments last longer. This cost-driven experimentation is raising alarms among healthcare professionals who warn of severe health risks.
At Apotek Hjärtat in Örebro, pharmacy manager Roro Wirlander Beydoun hears the same question repeatedly. "We have noticed that customers ask if they can change their dosing and experiment on their own, for example to make the medicine last longer," he says. "When I ask, I have gotten the answer that it can be about the money." The medications in question, GLP-1 analogs like Wegovy and Mounjaro, are not subsidized for weight loss alone in Sweden. A patient without type 2 diabetes can pay up to 4,000 SEK monthly out-of-pocket. For many in Stockholm's suburbs and beyond, that's a crushing sum.
The High Price of a New Solution
These drugs represent a seismic shift in obesity treatment. Professor Ylva Trolle Lagerros, an obesity specialist at Karolinska Institutet, acknowledges their transformative potential. "The new medicines have dramatically changed the possibility to treat obesity," she says. The positive effects on public health could be significant long-term. But the current reality is a two-tier system: those who can afford sustained treatment, and those who must improvise. In a society that values lagom – moderation and fairness – this disparity feels particularly stark. The Swedish model of universal healthcare clashes with the market reality of these breakthrough drugs.
"If you pay several thousand a month, it is not strange that you want to economize with them," Professor Trolle Lagerros notes, demonstrating empathy for the user's dilemma. The financial pressure is palpable. At Apoteket in Jönköping, specialist pharmacist Staffan Sundquist confirms the trend. Customers are actively seeking advice on modifying their prescribed regimens, a clear sign of widespread anxiety over cost.
A Dangerous Game of Self-Dosing
The move to self-adjust doses is where concern turns to urgency. "You should absolutely not buy and inject anything that you do not know what it is," Professor Trolle Lagerros states bluntly. This warning extends to the online marketplace, where counterfeit weight-loss injections are now marketed. The desperation to access these life-changing treatments is creating a fertile ground for fraud. On Swedish social media platforms and forums, tips on self-administering and dose-stretching circulate freely, often bypassing medical supervision entirely.
Wirlander Beydoun emphasizes the professional line. "I understand that the cost can be a problem, but a dose change should always be discussed with a doctor," he says. "Experimenting with doses on your own can affect the treatment negatively or lead to side effects." The risks are not merely theoretical. Incorrect dosing can diminish efficacy, cause adverse reactions like severe nausea or pancreatitis, and disrupt the careful metabolic management that the treatment requires.
Between a Rock and a Hard Place: The Patient's Perspective
To understand this, one must look at Swedish society's relationship with health and cost. The high-deductible system (högkostnadsskydd) is designed to cap annual medical expenses. Yet, for a chronic condition like obesity, the monthly outlay before reaching that cap can be insurmountable. This creates a cruel paradox: a highly effective treatment exists, but its cost places it out of reach for regular use, prompting risky workarounds. It's a story playing out not in clinics, but in the private calculations of individuals at their kitchen tables in neighborhoods from Södermalm to Spånga.
Professor Trolle Lagerros adds a critical nuance to the dosing debate. A lower dose is not automatically bad, she clarifies. Studies show it can mean fewer side effects and might reduce the risk of significant weight rebound when stopping. "But it should not be done on your own," she stresses. The key is the missing link: structured, professional guidance. The current situation sees patients making these consequential decisions in an information vacuum, torn between financial strain and the promise of better health.
The Systemic Strain and the Shadow Market
The explosion in demand—with Mounjaro topping Sweden's best-selling medication list in December—puts immense strain on the system. Healthcare providers scramble to manage expectations, while pharmacists become the frontline witnesses to the financial fallout. This crisis also fuels a dangerous shadow economy. The promotion of fake injectables online preys directly on this vulnerability. It represents a complete breakdown of the safe, regulated pharmaceutical chain Swedens are accustomed to, pushing people towards unverified and potentially hazardous sources.
This trend speaks to a broader cultural moment. Sweden is a nation that traditionally trusts authority and institutional expertise, from the Swedish Medical Products Agency to one's local vårdcentral. The act of self-dosing, encouraged by online forums, is a small but significant rupture in that social contract. It indicates a level of desperation where individuals feel the system cannot provide a feasible solution, forcing them to take matters—and syringes—into their own hands.
Seeking Solutions in a Cost-Conscious Society
So, where does Sweden go from here? The problem sits at the intersection of pharmaceutical innovation, healthcare economics, and social equality. Experts like Professor Trolle Lagerros see the long-term public health benefit, which argues for broader accessibility. The debate around subsidy models for obesity medication is likely to intensify. Should a condition with significant co-morbidities be treated with the same priority as others? Can cost-sharing models be adjusted?
In the meantime, the message from healthcare professionals is unified and clear. Communication is paramount. Patients must talk to their doctors about financial hardships. Pharmacists need to continue flagging these worrying inquiries to the broader medical community. The risks of DIY dosing or turning to the black market far outweigh any short-term savings. The Swedish principle of "folkhälsa"—public health—is built on collective safety and trust. That foundation is tested when effective treatment becomes a luxury good.
As the Swedish summer approaches, a time often associated with outdoor life and a focus on wellbeing, the contradiction is acute. The tools for a major health improvement exist, yet their access is fraught with financial and physical risk. The solution will require more than medical advice; it demands a societal conversation about value, cost, and what a right to health truly means in modern Sweden. Will the system adapt to make these treatments safely accessible, or will the dangerous mixtrande in the shadows continue to grow?