Challenges in accessing NHS prescribed Wegovy highlight gaps in the UK’s weight management services

In the UK, the rollout of the weight-loss drug Wegovy by the National Health Service (NHS) has been significantly less widespread than anticipated. Since its introduction, Wegovy has been prescribed approximately 3,300 times, a figure starkly lower than the 13,500 prescriptions projected by the National Institute of Health and Care Excellence (Nice) for the drug’s first year. This shortfall is attributed to a combination of factors, including an international shortage of the drug and a domestic scarcity of specialised weight management clinics required for its distribution.

The Financial Times, analysing NHS England data, notes that this slow uptake occurs amidst escalating demand, especially after recent endorsements from the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA has expanded Wegovy’s use not only for weight reduction but also as a preventative treatment against severe heart conditions and strokes in adults with overweight and obesity.

Compounding the issue, the NHS faces a shortage of the drug due to global supply constraints, which has led to a prioritisation of Ozempic—another drug by the same manufacturer, Novo Nordisk, intended for type-2 diabetes but containing the same active ingredient, semaglutide. This decision reflects the broader challenges in managing pharmaceutical supplies amidst varying clinical demands.

The limited availability of “tier 3” specialist weight management services, which provide comprehensive support including counselling, physiotherapy, and dietary advice, further hinders access. These services are crucial as they replicate the conditions of the clinical trials conducted by Novo Nordisk, yet there are barely over 20 such clinics across the UK, some with extensive waiting lists.

Nerys Astbury, a professor at Oxford University specialising in diet and obesity, highlighted the inconsistency in the availability of these services. “The provision of tier 3 weight management services is very patchy across the country. Some areas are well-serviced, whilst others lack these services entirely, or face significant delays,” she explained. This disparity has led some individuals to pursue private treatment, which is not a viable option for everyone due to the high costs—up to £299 for a month’s supply at commercial pharmacies like Boots.

Despite these obstacles, NHS prescriptions of Wegovy have been on a gradual rise, reaching about 770 by April from its UK approval in September of the previous year. Looking forward, projections indicate that by 2027, nearly 4 million Britons could qualify for semaglutide treatment under NHS guidelines, with expectations that almost 50,000 will receive it annually.

However, the Department of Health and Social Care has warned that drugs in the GLP-1 category, which includes Wegovy, may continue to face shortages until at least the end of 2024. In response, Novo Nordisk has prioritised maintaining a stable supply of Ozempic for diabetes patients over Wegovy, reflecting a strategic decision to meet critical healthcare needs first.

Despite these prioritisation efforts, the future of weight management drugs like Wegovy and the newly mentioned Mounjaro from Eli Lilly, which might soon be prescribed without the need for tier 3 services, points towards a potential shift in how obesity treatments are administered in the UK. Professor Astbury remains cautiously optimistic about these developments, yet she underscores the necessity for readiness in service provision: “It’s promising that access might improve, but we must ensure that the healthcare settings are prepared to support patients effectively.”

In summary, while Wegovy offers significant potential in combating obesity and related health issues, its effective deployment within the NHS is hampered by systemic issues in drug supply and specialised service availability. These challenges highlight the need for strategic improvements in healthcare logistics and infrastructure to better serve the population’s needs.