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The status of a weight loss drug pilot scheme in England is “unclear” with participants “stood down” and the rollout “paused”, according to the Obesity Health Alliance (OHA).
In a report published on 16 October 2024, the OHA said it is not known if the pilots for the provision of Wegovy (semaglutide; Novo Nordisk) “have been formally scrapped”.
Meanwhile, it also said that waiting lists for overweight and obesity management services were “routinely reaching three to five years”, with some services closed to referrals owing to capacity exceeding demand.
An open letter sent to Wes Streeting, secretary of state for health and social care, on 16 October 2024 — coordinated by the OHA and backed by more than 200 NHS professionals — has called for “an urgent comprehensive review of overweight and obesity treatment services across England”, in response to long-standing issues and “an unprecedented public demand” for new pharmaceutical treatments.
The letter warned that the introduction of new obesity drugs was placing “immense pressure” on NHS services in England and that the upcoming National Institute for Health and Care Excellence’s (NICE) approval of tirzepatide (Mounjaro; Eli Lilly) for treatment of obesity could place additional pressure on the system, urging the government to help clinicians prioritise access to weight loss drugs and tackle inequalities in access to services.
A spokesperson for Diabetes UK, which currently hosts the OHA secretariat, told The Pharmaceutical Journal: “Wegovy requires specialist services to be accessed so is currently putting strain on the already patchy provision of services.
“Things are likely to change with NICE proposing that Mounjaro doesn’t have to be accessed via a specialist weight management service and that primary care can prescribe. However, it still will only be recommended to be prescribed with the right level of support (dietary, exercise, psychological advice).
“As acknowledged by NHS England in their proposed funding variation request for this drug, a whole new pathway needs to be established, which will take time and resources. They have suggested it will take years. Our report calls for decisive action to be taken across the overweight and obesity pathway to counter the range of barriers in place.”
Paul Wright, consultant cardiovascular pharmacist at Barts Health NHS Trust, said that the report “certainly describes what we see in practice with variation in access to overweight and obesity management services”.
“With advances in pharmacotherapy there is a need to optimise the pathways and provide more equitable access to existing and future therapies.”
Wright added that the government had recently announced a collaboration with Eli Lilly to work on a programme to tackle obesity.
“With a systems-based change to overweight and obesity management services, standardising access and services, and sustained longer term funding, it is hoped that we can have significant impact on the obesity epidemic,” he said.
In response to The Pharmaceutical Journal’s request for information on the Wegovy pilot and service, a spokesperson for the Department of Health and Social Care said: “Obesity is one of the biggest preventable killers. It costs the NHS more than £11bn a year and it also places a significant burden on our economy. By tackling obesity, we can ease demands on our NHS and help improve Britain’s productivity.
“Obesity drugs may be part of the solution, and as well as backing the next generation of medicines, this government is also taking action to prevent ill health in the first place and help people live well for longer. We’re tackling the obesity crisis head-on — restricting junk food advertising on TV and online, along with stopping fast food shops targeting school children.”
In June 2023, the Conservative government announced a £40m two-year pilot scheme to explore how weight loss injections can be made available to more people by expanding specialist weight management services outside hospital settings.
In a contract tender published in December 2023, NHS England said that, as part of the pilot scheme, a community pharmacy “dispense and delivery service” would be commissioned to provide weight loss drugs to patients as part of an NHS specialist weight management service pilot programme, to broaden the provision of glucagon-like peptide-1 receptor agonists.
In June 2024, NICE recommended tirzepatide for managing overweight and obesity in draft guidance ‘Tirzepatide for managing overweight and obesity’, following positive results from clinical trials — results of which showed that patients lost an average of 20.9% of their bodyweight in 36 weeks.
