The UK’s regulatory body, NICE, has recommended the use of semaglutide (also called Wegovy or Ozempic) alongside a reduced-calorie diet and increased physical activity to adults who have at least 1 weight-related comorbidity and a body mass index (BMI) of at least 35kg/m2. A weight-related comorbidity could be one of: dysglycaemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia (in which disturbances in fat metabolism lead to changes in the concentrations of lipids in the blood), obstructive sleep apnoea or cardiovascular disease.
It will be available to NHS patients soon when the launch of the drug in England is confirmed by manufacturer Novo Nordisk. The publication of final guidance requires the NHS in England to implement the NICE recommendations within three months of the product becoming commercially available.
Patients inject themselves once a week with pens pre-filled with semaglutide. The drug suppresses appetite by mimicking the hormone glucagon-like peptide-1 (GLP-1), which is released after eating. It makes people using it feel full, thereby resulting in people eating less and reducing their overall calorie intake.
“For some people losing weight is a real challenge which is why a medicine like semaglutide is a welcome option. It won’t be available to everyone. Our committee has made specific recommendations to ensure it remains value for money for the taxpayer, and it can only be used for a maximum of two years,” said Helen Knight, director of medicines evaluation at NICE. “We are pleased to finally publish our final guidance on semaglutide which will mean some people will be able to access this much talked about drug on the NHS.”
Semaglutide can only be prescribed for a maximum of two years within a specialist weight management service providing multidisciplinary management of overweight or obesity (including but not limited to services in tiers 3 and 4). This recommendation mirrors the clinical and financial modelling supplied by the company that people are treated for a maximum of two years in specialist weight management services.
Clinical trial evidence shows that people lose more weight with semaglutide alongside supervised weight loss coaching than with the support alone. Evidence from the STEP 1 clinical trial, a randomised double-blind trial, showed that participants taking semaglutide lost on average 12% more of their body weight compared with placebo. During clinical trials patients reported the main side effects were gastrointestinal disorders including nausea, diarrhoea, constipation and vomiting.
The 2019 Health Survey for England estimated 28% of adults in England were obese and a further 36% were overweight. Government estimates indicate that the current costs of obesity in the UK are £6.1 billion to the NHS and £27 billion to wider society.