Thousands of people will soon be able to be prescribed a drug, semaglutide, to help them lose weight as part of their treatment in an NHS specialist weight management service.
The drug, sold under the trade name Wegovy, has been promoted by Hollywood stars. It can help people using it to reduce their weight by suppressing appetite, but reports suggest that they tend to put the weight back on when they stop using the drug.
NICE, the National Institute for Health and Care Excellence, says that use of the drug can promote weight loss of 10 per cent when used with support of a multidisciplinary team. These professionals are experts on coaching people on lifestyle interventions and will also monitor the drug’s potential side-effects.
NICE has recommended the use of semaglutide alongside a reduced-calorie diet and increased physical activity to adults who have at least one other weight-related condition such as diabetes, and a body mass index (BMI) of at least 35kg/m2.
People with an BMI of between 30-34.9 kg/m2, with one weight-related comorbidity who are eligible for referral to specialist weight management services could also be prescribed the drug.
Comorbidity
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.
Semaglutide will be available to NHS patients soon when the launch of the drug in England is confirmed by manufacturer Novo Nordisk.
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.
The publication of final guidance on 8th March 2023 requires the NHS in England to implement the NICE recommendations within three months of the product becoming commercially available.
Helen Knight, director of medicines evaluation at NICE, said: “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.
“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.
Supervised
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.
An independent committee recommended its use in final draft guidance in June 2022, but NICE has been unable to publish final guidance until now because the product had not been scheduled to launch in England.
