Europe faces long wait for weight-loss drugs as governments eye costs
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[July 10, 2023]
By Ludwig Burger and Andreas Rinke
FRANKFURT (Reuters) - Novo Nordisk will start selling its hugely popular
obesity drug Wegovy in Germany this month, its third European market,
but only people who pay from their own pocket or have certain private
health insurance plans will be able to get it.
A decades-old German law bans public health insurance schemes from
paying for weight-loss drugs, categorizing them alongside pills for
impotency or baldness as a lifestyle choice rather than a health
necessity.
That means the cost of Wegovy, which has a U.S. list price of $1,350 a
month, will not be reimbursed for the 90% of Germans covered by such
plans. Novo has yet to set a price for Wegovy in Germany, Europe's
largest pharma market.
Germany's stance on weight-loss drugs is among the region's strictest,
even though the proportion of its citizens who are overweight is above
the European Union average.
It highlights the challenge Novo and rivals face in convincing European
governments to pay for obesity drugs, which analysts say is likely to
slow their take-up there.
Some doctors argue that Wegovy could help stem a tide of weight-related
conditions such as heart disease or joint pain that are themselves
costly to treat.
Martin Merkel, a medical professor and member of the German
Endocrinology Society, said the drug offered a "very, very good
opportunity" to reduce weight and prevent follow-on disease.
![](http://archives.lincolndailynews.com/2023/Jul/10/images/ads/current/napa_sda_HEROES_2023.png)
"How many knees would not have to be operated on if we were all
slimmer?" said Merkel, adding that pushing diet and exercise alone has
shown limited success.
Other researchers, including dietician and senior lecturer Duane Mellor
of Aston University in Birmingham, England, say promoting a healthier
lifestyle should take precedence over prescription drugs.
SLOWER THAN EXPECTED
Production problems and a struggle to keep up with overwhelming U.S.
demand have already led to a slower-than-expected roll out of Wegovy in
Europe.
Novo boss Lars Fruergaard Jorgensen said in a newspaper interview on
June 24 that the Danish company would launch the drug in Germany at the
end of July.
Germany's health ministry told Reuters there were no plans to change the
law to cover weight loss drugs.
One lawmaker in Berlin cited concerns about the cost weighing on an
over-stretched health budget. The lawmaker, who did not want to be
named, said expert panels governing reimbursement would review any
benefits of the drugs beyond just weight loss, the usual system for
approvals.
Michael Wirtz, who represents patients at advocacy group Obesity Help
Germany, says this is short-sighted. Weight-loss drugs could prolong
lives and help people stay in the workforce.
"This is not about people needing to be lean and attractive," he said.
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![](../images/071023PIX/health17.jpg)
The logo of Danish multinational
pharmaceutical company Novo Nordisk is pictured on the facade of a
production plant in Chartres, north-central France, April 21, 2016.
REUTERS/Guillaume Souvant//File Photo
![](http://archives.lincolndailynews.com/2023/Jul/10/images/ads/current/debbiesfloral_lda_060123.png) Germany is not the only government
to impose limits.
Public health insurance schemes in Norway and Denmark, the other two
European countries where Wegovy is available, will not pay for the
drug, arguing that monthly costs of between $160 and $350 are too
high compared to the benefits.
Denmark's largest private health insurer will also stop paying for
it next year due to high demand.
French payment schemes will only cover its use for treating very
obese people with a body mass index (BMI) of 35 or over, a higher
minimum than European regulators indicated when they approved the
drug in January 2022.
Access in Britain will initially be through hospital specialists and
limited to people with a BMI of 35 or over. The government plans to
authorize family doctors to prescribe the drug only after a two-year
pilot scheme.
DIFFERENT PICTURE
In the United States, the federal Medicare health plan for older
Americans is prohibited from covering weight-loss drugs.
Many health plans paid for by large employers will cover Wegovy,
although they may require that patients try a rigorous diet program
or cheaper drugs first.
"In Europe and the rest of the world, there is going to be much more
variability," said Terence McManus, fund manager at
Switzerland-based Bellevue Asset Management.
Barclays analysts estimate the global market for obesity drugs will
increase to more than $60 billion by 2030 from $2.9 billion in 2022,
about 60% of which will be in the United States and around 26% in
the European Union.
![](http://archives.lincolndailynews.com/2023/Jul/10/images/ads/current/LPL_small%201.gif)
At present, around 53% of people across the 27-country EU are
overweight or obese compared with roughly 74% in the United States,
although the EU statistics office has warned that weight problems
are rapidly increasing in most member states.
But for Europe's mostly universal health schemes, a surge in costs
is a bigger fear than a rise in weight-related problems over time,
said Phil McEwan, CEO of health economics consultancy Heor in
Cardiff, Wales, who advises Novo on market access.
"There are many more morbidly obese people in the U.S.. You could
argue they've got more to gain," said McEwan.
(Additional reporting by Patricia Weiss in Frankfurt; Editing by
Josephine Mason and Catherine Evans)
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