People in Britain who can afford to pay out of their own pocket may get easier access to Novo Nordisk’s weight-loss drug Wegovy than those seeking treatment in the country’s state-run health service, some doctors and medical experts warned on Monday.
That risks worsening health inequality in the country with the highest obesity levels in Europe when Britain’s National Health Service (NHS) is under increasing financial strain and struggling with record waiting times.
Wegovy maker Novo Nordisk announced on Monday the launch of the drug in Britain, its fifth market, making it available on the NHS weight management scheme, where it will be prescribed for free, but also on the private market.
Novo said on Monday that it would allocate a portion of available supply for the NHS, which said around 50,000 patients could be eligible in England, but cautioned that supplies will be constrained for the foreseeable future.
Naveed Sattar, a Professor of Metabolic Medicine at the University of Glasgow who has consulted for Novo but said he had no knowledge of its decision-making process, said he was “not comfortable” with Wegovy being available privately.
“It just doesn’t make sense to me because there is substantial need in the NHS. Why wouldn’t we put all that (supply) through the NHS?” he said.
A 2019 Organisation for Economic Co-operation and Development (OECD) report said that nearly one in three adults are obese in the United Kingdom, the highest level in Europe.
In the most deprived areas in England, prevalence of obesity or being overweight is 14 percentage points higher than in the least deprived areas, data for 2020/21 show, according to a NHS report published in January.
Many obese people who live in poverty or face other barriers such as not speaking fluent English may struggle to access the NHS specialist service, said Duane Mellor, a dietician and senior lecturer at Aston University’s medical school.
The specialist weight management service provided by the NHS is also relatively small compared with potential demand, doctors said.
The NHS declined to answer questions on the access concerns raised by the doctors, referring Reuters to its earlier statement on the launch.
LIMITED SUPPLIES
Wegovy, shown to help patients reduce body weight by around 15% when used along with exercise and lifestyle changes, is also available in the United States, Norway, Denmark, and Germany.
But Novo has had to limit supplies of starter doses in the U.S. due to supply shortages and soaring demand, while German doctors also say supplies are low.
Two of the country’s leading private insurers, Aviva AV.L and AXA Health, said they would not cover Wegovy.
Even so, high levels of demand from people paying out of their own pocket for Wegovy, which is injected monthly, may also further hamper Novo’s ability to produce enough of the drug as it tries to expand in Europe.
In a sign of pent-up private demand, UK-based Simple Online Pharmacy said that more than 50,000 people had registered an interest in Wegovy on its website.
Furthermore, doctors prescribing Novo’s type 2 diabetes treatment Ozempic for weight-loss has caused shortages of that drug in Britain, the government said on Monday. Ozempic contains the same active ingredient as Wegovy, but in a lower dose.
Private providers are locking in supplies.
Simple Online Pharmacy expects to have Wegovy in stock “within the next 24 hours”, while Numan, an online men’s healthcare company, said it is finalising its stock quota with Novo this week and intends to fill prescriptions this month.
Some of the main providers of weight-care medications in Britain, Simple, Walgreens Boots Alliance WBA.O and Superdrug said they would charge private patients from 195 pounds for a monthly supply of Wegovy.
The criteria for doctors prescribing Wegovy privately is different to those set out under the NHS, potentially widening access to more people.
Juniper, a venture capital-backed private online clinic, said it will prescribe Wegovy to anyone with a body mass index (BMI) above 27 with a weight-related comorbidity.
Under the NHS, Wegovy would be prescribed to people with at least one weight-related condition and a BMI of 35 or more, or a BMI of 30 or more who are already treated within the NHS specialist weight management service.
“Using private providers will almost certainly mean that some of those who need the drug most will not be able obtain the drug,” said Richard Holt, professor in diabetes and endocrinology at the University of Southampton.
Launches of Novo Nordisk’s weight-loss drug Wegovy:
USA – $1,350 (€1252) per monthly treatment
Wegovy was launched in the U.S. in June 2021 but it took Novo until December 2022 to make all doses available there because of an initial production outage.
The list price of four-week treatment is about $1,350, regardless of dosage, not taking any coupons and rebates into account.
The weekly injections are started at 0.25 milligrams of active ingredient semaglutide and gradually increased to the maintenance dose of 2.4 milligrams.
DENMARK – €318 per monthly treatment
Wegovy was made available in all dose strengths in Denmark in early 2023. A four-week supply of the maintenance dose costs 2,370.60 Danish crowns ($343.59).
The public health care system in Denmark does not reimburse any weight-loss drugs and the country’s largest private health insurer, which insures roughly half the country’s population, will stop reimbursing weight-loss medication from January next year due to high demand.
The Danish ministry of health has said reimbursing Wegovy would cost the state as much as $4 billion each year.
NORWAY – €240 per monthly treatment
In Norway, Wegovy was launched in all dose strengths in early 2023. The four-week supply of the maintenance dose costs 2,775.30 Norwegian crowns ($261.13).
Norwegian Medicines Agency said in January it would not subsidise the drug for treatment of obesity, saying the price would be too high in relation to the documented health effects.
GERMANY – €302 per monthly treatment
Wegovy was launched in Germany on July 29, priced at 301.91 euros ($325.97) for four weeks at maintenance dose. Starter dose is priced at 171.92 euros for four weeks.
The cost of the drug will not be reimbursed for about 90% of Germans covered by public health insurance plans, under a law that bans them from covering weight-loss drugs.
For the 10% with private health insurance, coverage varies. Insurer Allianz ALVG.DE has said it would pay for the drug if the person treated is diagnosed with a medical need, while rival Debeka said its plans excluded weight-loss treatments.
BRITAIN- £299 (€350) per monthly treatment
Wegovy was made available in Britain on Sept. 4, in what Novo called a “controlled and limited launch”. The company has not specified the price or how much it would supply.
Simple Online Pharmacy, a UK-based online pharmacy chain, said it would sell Wegovy in the range of 199 pounds to 299 pounds ($251-$377) including a consultation with a general practitioner, prescription and dispensing costs.
Novo said the drug would be available both within the National Health Service’s weight management scheme and “privately through a registered healthcare professional”.