Pent-up private Wegovy demand prompts UK availability concerns

[September 05, 2023]  By Maggie Fick

LONDON (Reuters) -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.

A 0.25 mg injection pen of Novo Nordisk's weight-loss drug Wegovy is shown in this photo illustration in Oslo, Norway, September 1, 2023. REUTERS/Victoria Klesty/Illustration/File Photo

Two of the country's leading private insurers, Aviva 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 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.

(Reporting by Maggie Fick; Additional reporting by Alistair Smout in London; Editing by Josephine Mason and Alexander Smith)

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