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Weight-loss drugs could be prescribed online and via apps, draft guidance from the National Institute for Health and Care Excellence (NICE) has said.
An early value assessment of “digitally enabled technologies to support treatment with weight-management medication in specialist weight-management services”, published on 15 August 2023, says that four digital weight-loss monitoring and mentoring programmes, delivered online or via an app, could be made available to eligible people in England.
The four digital services — Liva, Oviva, Roczen and Second Nature — would be used for four years while evidence is gathered on their effectiveness, the guidance says.
NICE said that some of the digital programmes include the ability to prescribe weight management medication, such as semaglutide (Wegovy; Novo Nordisk) or liraglutide (Saxenda; Novo Nordisk), to people who are eligible.
Calculations by NICE show that up to 48,000 people would be able to access the virtual services, with early evidence suggesting that “weight loss of those using these digital platforms is similar at 2 years, compared with face-to-face specialist weight management services”, NICE said.
If approved, people referred to these services will have an in-person clinical assessment before starting treatment and must meet the criteria for accessing weight management medication of at least one weight-related comorbidity, such as diabetes or high blood pressure, and a body mass index (BMI) of at least 35.0kg/m2, or at a lower threshold in certain circumstances.
The draft guidance says: “There is an unequal distribution of specialist weight-management services across the NHS, and in some areas there is no access to them.
“In areas where there are services, there is an increasing number of people on waiting lists because of limited resources and funding. The clinical experts estimated that 30% to 70% of people do not have access to a local specialist weight-management service. They also estimated that 10% to 30% of people are unable to attend face-to-face appointments because of time commitments or mental health reasons.”
Mark Chapman, interim director of medical technology and digital evaluation at NICE, said: “Traditional face-to-face services treating people living with obesity are unable to keep up with demand. Waiting lists are long, some areas don’t have a service, and patients need a solution.
“These four platforms could provide an option to accessing weight management support to those people who live in an area with no specialist weight management services or for those who are on a waiting list and are happy to be treated safely outside a hospital setting.
”By using these platforms over the next four years, NICE can learn from the evidence generated to ensure that when we carry out a full assessment, we can ensure that we are balancing delivering the best care and getting value for money for the taxpayer.”
Liva is the only one of the four platforms currently available for use by the NHS. Oviva, Roczen and Second Nature could be used if they are granted appropriate Digital Technology Assessment Criteria approval from NHS England.
A consultation on the NICE draft guidance closes on 24 August 2023.
