WHO to consider adding obesity drugs to 'essential' medicines list
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[March 29, 2023]
By Jennifer Rigby
LONDON (Reuters) - Drugs that combat obesity could for the first time be
included on the World Health Organization's "essential medicines list,"
used to guide government purchasing decisions in low- and middle-income
countries, the U.N. agency told Reuters.
A panel of advisers to the WHO will review new requests for drugs to be
included next month, with an updated essential medicines list due in
September.
The request to consider obesity drugs was submitted by three doctors and
a researcher in the United States. It covers the active ingredient
liraglutide in Novo Nordisk's obesity drug Saxenda, which will come off
patent soon, allowing for cheaper generic versions.
The panel could reject the request or wait for more evidence. A decision
by the WHO to include Saxenda and eventual generics on the list would
mark a new approach to global obesity by the health agency.
It could also pave the way for a newer, more powerful treatment from
Novo Nordisk called Wegovy to be recommended for low- and middle-income
countries in future.
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However, some public health experts warn against introducing such
medicines too broadly as a solution to a complex condition that is still
not completely understood.
"Obesity is an increasingly important health problem in many countries,"
said a WHO spokesperson. "Medicines for the treatment of obesity are
only one aspect of management, of course, and prevention is also
crucial."
The WHO said the expert panel would consider the evidence for
liraglutide over the coming months. They may also seek a broader
evaluation of other types of weight-loss treatments in the future.
Over 650 million adults worldwide are obese, more than triple the rate
in 1975, and roughly another 1.3 billion are overweight, according to
the WHO. The majority – 70% - live in low- and middle-income countries.
EXPANDING ACCESS
Including obesity drugs among the WHO's essential medicines could have
great significance for that population. Experts say that adding HIV
drugs to the list in 2002 helped to make them much more widely available
to AIDS patients in poorer countries.
“At present, there are no medications included in the (list) that
specifically target weight loss for the ongoing global burden of
obesity,” wrote U.S. researcher Dr. Sanjana Garimella from Yale New
Haven Health, Dr. Sandeep Kishore from the University of California, San
Francisco, and colleagues to the WHO in requesting the addition. They
did not respond to Reuters requests for comment.
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A logo is pictured on the World Health
Organization (WHO) headquarters in Geneva, Switzerland, November 22,
2017. REUTERS/Denis Balibouse
![](http://archives.lincolndailynews.com/2023/Mar/29/images/ads/current/fcs_funeral_lda_border_04029022.png) They argue that while the list
includes mineral supplements for nutritional deficiencies, the lack
of weight-loss treatments represents a "discrepancy" in global
health equity, given the increasing number of deaths in poorer
nations hastened by weight-related illness, including heart disease
and diabetes.
Saxenda, a once-daily injection, has been shown to help people
reduce 5%-10% of their body weight, at $450 per month in the United
States and $150 per month in Europe.
People using Wegovy, a weekly injection that costs more than $1,300
a month in the United States, have lost up to 15% of their weight.
At the moment, Wegovy is in short supply and Novo is prioritizing
its launch and distribution in the U.S. and other wealthy markets.
The Danish drugmaker in a statement said it was not involved in the
application to consider liraglutide for inclusion on the WHO list,
adding, "we welcome the WHO review and look forward to the readout
and decision."
Both drugs belong to a class of medicines called GLP-1 receptor
agonists, which have been used for years to treat diabetes. They
affect hunger signals to the brain and slow the rate at which a
person’s stomach empties, making them feel fuller longer. Eli Lilly
and Co has a similar diabetes drug nearing approval for weight loss.
For both Saxenda and Wegovy, there is a lack of long-term safety and
effectiveness data for obesity. Studies suggest people will likely
have to take the drugs for the rest of their lives to keep the
weight off.
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High-income countries are taking varying approaches for how to use
these medicines, including contemplating whether they can be
prescribed by government-sponsored health systems or covered by
insurance, as they are for diabetes. In some countries, their use is
being reserved only for the most at-risk groups.
Professor Zulfiqar Bhutta, an obesity expert at the University of
Toronto, said the phenomenon of obesity in low- and middle-income
countries must be better understood to help determine the best
course of action
"Preventive strategies and sustained efforts at education,
gender-focused interventions, must take precedence over the use of
obesity drugs, which require a lot more research for safety and
effectiveness," he said.
(Reporting by Jennifer Rigby; Editing by Michele Gershberg and Bill
Berkrot)
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