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A community pharmacy “dispense and delivery service” is to be commissioned to provide weight loss drugs to patients as part of an NHS specialist weight management service (SWMS) pilot programme.
A contract tender, published by NHS England on 18 December 2023, says that the contract will include dispensing and delivering medicines to patients’ home addresses as part of a pilot scheme to broaden the provision of glucagon-like peptide-1 receptor agonists.
In June 2023, the government announced the £40m pilot scheme to “explore how approved drugs can be made safely available to more people by expanding specialist weight management services outside of hospital settings”, including looking at how GPs could safely prescribe these drugs and how the NHS can provide support in the community or digitally.
The tender for the community pharmacy dispense and delivery service says the NHS England-run pilot scheme will “consist of several pilots across a small number of integrated care boards (ICBs) within England that will test the delivery of three innovative models of delivery from general practice, existing Tier 3 services and new digital provision for Specialist Weight Management Services and pharmacotherapy”.
It adds that the pilot will include the dispensing and delivery of specific obesity medicines, which are licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) and the subject of a relevant National Institute for Health and Care Excellence (NICE) technology appraisal.
In March 2023, NICE recommended the use of semaglutide (Wegovy; Novo Nordisk) for adults with a body mass index of at least 35 and one weight-related health condition, such as type 2 diabetes mellitus or hypertension.
The NICE guidance states the medication can only be prescribed within specialist weight loss services, which offer comprehensive dietary, lifestyle and behaviour modification support.
The recommendation was followed by a “controlled and limited launch” of the drug in September 2023, after a national patient safety alert warned of shortages of GLP-1 receptor agonists in July 2023, citing use of off-label prescribing for weight loss as a reason.
In October 2023, a NICE early value assessment also identified four apps that could be used to prescribe weight loss drugs for adults who are eligible for weight-management medicine.
Pharmacies wanting to provide the dispense and delivery service must have a “national footprint” because of the need to deliver to patients’ addresses, the contract tender says.
A spokesperson for Community Pharmacy England said the vision for community pharmacy that it commissioned from The King’s Fund and The Nuffield Trust, and published in September 2023, recommended that pharmacies could provide weight management services as part of a nationally enhanced service.
