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The National Health Service has prescribed weight-loss drug Wegovy far less often than expected since its launch, as it struggles with a shortage of weight management clinics to distribute the popular treatment.
Financial Times analysis of NHS England data shows Wegovy was prescribed just 3,300 times since September, far below the 13,500 patients that the healthcare spending watchdog the National Institute of Health and Care Excellence (Nice) expects will receive the drug in its first year of use.
The slow start to Wegovy prescriptions comes as demand is set to increase. On Tuesday, the Medicines and Healthcare products Regulatory Agency (MHRA) said Wegovy could be prescribed to reduce the risk of serious heart problems or strokes in overweight and obese adults, as well as its current use for weight loss.
But Wegovy is in short supply internationally and the NHS said it has prioritised supplies of Ozempic, another drug made by Danish manufacturer Novo Nordisk that uses the same active ingredient but is used for type-2 diabetes, over Wegovy.
The shortfall in Wegovy prescriptions is also the result of a lack of specialist NHS weight-loss services. Under Nice recommendations, Wegovy can be prescribed by the NHS through these services to people with a body-mass index (BMI) over 35, or over 30 with another weight-related condition, for a maximum of two years.
The clinics offer counselling, physiotherapy and healthy eating advice, and have specially trained staff, in conditions that are similar to those under which Danish manufacturer Novo Nordisk conducted Wegovy clinical trials.
But there are just over 20 of these so-called “tier 3” services across the country, with some NHS trusts reporting long waiting lists to access treatment.
Uneven access could lead to poorer patients being frozen out from accessing Wegovy, while wealthier users pay over the counter. At high-street pharmacist Boots, Wegovy costs £199 for four weekly doses for those starting treatment, rising to up to £299 for higher doses.
Nerys Astbury, an Oxford university professor researching diet and obesity, said that tier 3 weight management services are “very patchy across the country. Some areas do have them, for some areas they are completely absent and in other areas, there is a waiting list to access those services”.
“People are going to seek Wegovy privately because they know there may be difficulty or delays in accessing it through the NHS. But that’s not an option for everybody,” she added.
NHS prescriptions of the appetite-suppressing injection have increased each month since it was approved in the UK in September last year to around 770 in April, according to FT analysis.
This is likely to rise further: by 2027, 4mn Britons are expected to meet the guidelines for the drug and Nice expects almost 50,000 each year to receive semaglutide, the active ingredient in Wegovy, via the NHS.
Novo Nordisk has also struggled to meet high global demand for the product, which has shown to give users up to 15 per cent weight loss in clinical trials.
In the UK, GLP-1s drugs — the category that includes Wegovy — are expected to be in short supply until at least the end of 2024, the Department of Health and Social Care said in January.
Novo Nordisk also markets semaglutide under the brands Rybelsus and Ozempic, which the MHRA has approved for diabetes management but have commonly been used off-label for weight loss. NHS patients have filled millions of prescriptions for each since 2019, the data showed.
The service said it had prioritised Ozempic supply, saying it had “taken steps to ensure that patients with type 2 diabetes can continue to receive the treatment they need, and this has taken clinical priority”.
Novo Nordisk said it “has made it a priority to provide a protected supply of Wegovy to the NHS” but declined to state how many drugs would be available through the health service. About 80 per cent of non-US Wegovy sales are paid out-of-pocket.
Meanwhile, people with a BMI above 35 will have access to Mounjaro, the weight-loss drug produced by US company Eli Lilly, after Nice issued draft guidelines in June.
GPs would soon be able to prescribe the drug without the need for tier 3 weight management services, in part because of its different trial design to Wegovy, Astbury said.
“That’s great because it will increase access but our concern is, are those settings ready for that?” she said, as some guidance from GPs may still be required for those taking the drugs.
