Britain plans to launch a pilot programme exploring how new weekly weight-loss shots such as Novo Nordisk's Wegovy can be given to obese patients by general practitioners even as the drug's market launch remains unclear.
The government's announcement on the £40 million pilot programme comes after drug cost-effectiveness watchdog NICE in March recommended the use of Wegovy in adults with at least one weight-related condition and a body mass index of 35, but only within the NHS specialist weight management scheme.
The timing of Wegovy's launch in Britain - which would be only the fourth country to use it - is uncertain, however, after Novo last month rationed starter doses to secure supply to U.S. patients already on the regimen, after it was overwhelmed by demand there.
British Prime Minister Rishi Sunak said on Wednesday (May 7) the pilot and fighting obesity-related diseases could reduce pressure on hospitals.
It would also support "people to live healthier and longer lives, and helping to deliver on my priority to cut NHS waiting lists".
The NHS endured a tough winter in England in particular, with waiting lists hitting record highs and staff striking for higher pay amid double-digit inflation.
Obesity is one of the leading causes of severe health conditions such as cardiovascular disease, diabetes and cancer, and costs the NHS 6.5 billion pounds a year.
The government said that NICE was also considering potential use of Eli Lilly's Mounjaro, also known as tirzepatide, currently licensed to treat diabetes but expected to win approval to treat obesity as well.
The two-year pilot will be launched after the new weight loss drugs are available in the UK, it said.
Rising demand in US causes launch delays in UK
Novo's inability to keep up with U.S. demand for Wegovy has effectively delayed the launch in Britain and elsewhere in Europe. It has also had to overcome production problems at a contract manufacturer.
A company spokesperson would not comment on any commitment to supply the programme, but said there had been preliminary discussion on the role of treating obesity as part of the UK government's ambition to bring people back into the workforce.
Eli Lilly said that its Mounjaro drug could be part of the solution, once approved.
The government said that only 35,000 people would have access to Wegovy under the specialist hospital services, but tens of thousands more could be eligible.
Phil McEwan, CEO of health economics consultancy Heor Ltd in Cardiff, who advises Novo on market access, said the need for specialist services would have been a major bottleneck.
"You have to be referred to specialist care and that’s not the easiest thing to do. The challenge will be to access reimbursement," he said.
Keen interest in the treatment is already showing elsewhere. One of Britain's largest pharmacy chains, Superdrug, said its remote prescriptions service was anticipating significant demand.
"Superdrug Online Doctor has seen five time anticipated levels of registration," a spokesperson told Reuters in April, declining to give numbers.
Outside the U.S., Wegovy has only been launched in Denmark and Norway but major medical insurance schemes there will not pay for it, saying the health benefits would not justify the extra budgeting.
Britain's move is likely to heat up a debate about whether a drug is the right answer to the growing public health problem of obesity or whether there are other ways to encourage healthier lifestyles.
Duane Mellor, a dietitian and senior lecturer at Aston University's medical school, said drugs like Wegovy were a tool, not the solution.
"It’s a political decision to say the government is doing something to tackle health issues linked to obesity... we need to be much braver and bolder in looking at root causes around access to health care and about making healthy food enjoyable."
Simon Cork, a senior lecturer in physiology at Anglia Ruskin University, said obesity had been shown to be "incredibly difficult" to manage through diet and exercise alone and that Wegovy and similar drugs offered a step change.
"Hence the excitement from the general public and why the UK government seems to be pushing to make the drug available widely," he said.
Wegovy works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that triggers the feeling of fullness in the body after eating.
Trials showed it leads to an average weight loss of around 15%, alongside changes to diet and exercise.
