Private pharmacy semaglutide services must provide long-term support, say experts

Exclusive: Online pharmacies and large multiples are already signing patients up to receive information about their new private semaglutide services as soon as the drug becomes available in the UK, which is expected to be soon.
Woman injecting herself in stomach

Obesity experts have raised concerns over private weight loss schemes providing semaglutide (Wegovy; Novo Nordisk) planned by some community pharmacies.

Online pharmacies and large multiples, such as Boots, LloydsPharmacy and Superdrug, are already signing patients up to receive information about their new private semaglutide services as soon as the drug becomes available in the UK, which is expected to be soon.

However, experts have warned that this setting may be inappropriate because patients require long-term multidisciplinary support, including counselling, to change their approach to food.

Semaglutide is a once-weekly injectable treatment, which has been recommended by the National Institute for Health and Care Excellence (NICE) for a maximum of two years in people with obesity and at least one risk factor.

NICE states it can only be used as part of tier 3 or 4 NHS weight loss services, which offer comprehensive dietary, lifestyle and behaviour modification support.

The approval for use follows results from the STEP 1 trial, published in March 2021, which showed an average of 15% weight loss over 68 weeks with semaglutide compared with 2% in those given placebo. All trial participants were given diet and lifestyle support.

The cost of semaglutide in the UK has not yet been confirmed; however, the NHS list price of Ozempic — Novo Nordisk’s other semaglutide product licensed for use in type 2 diabetes mellitus — is £73 for a pack of four syringes.

When asked by The Pharmaceutical Journal, a spokesperson for Novo Nordisk said there is no confirmed UK launch date although it was working to make Wegovy available “as soon as possible”.

Several community pharmacy multiples already provide private weight loss services, some of which include the offer of liraglutide, a daily weight loss injection that works in the same way as semaglutide, at a cost of around £240 per month.

However, Tam Fry, chair of the National Obesity Forum, told The Pharmaceutical Journal: “Whenever supplies of Wegovy finally arrive in the UK, it is essential that any private company selling this powerful drug provides the back-up that NICE advises. 

“It is not a medication to be casually bought … by anyone simply wanting to lose some weight. It should be taken only by the seriously overweight under supervision.”

Hannah Beba, consultant pharmacist in diabetes at West Yorkshire Health and Care Partnership, said demand for private services will be huge but there ought to be a cautious, staged introduction of the drug. “My concern is that we do it all at once, and we can’t learn from any of it because it’s just going to be chaos.

“We are walking a very fine line with this drug and we need to be very cautious with it as a profession. We could end up doing ourselves a lot of damage and we need to treat this drug with the respect that it deserves,” she said.

Duane Mellor, registered dietitian and senior lecturer at Aston University Medical School, said private providers may struggle to provide support in the longer term because weight loss is not a “temporary journey”.

“You need more than 12 weeks of support to get back to having a healthy relationship with food,” he said.

When approached with these concerns by The Pharmaceutical Journal, a spokesperson for Superdrug said patients would have to complete a questionnaire, which requests information about their BMI as well as photos of themselves on a scale.

“Our doctors will then review and ensure the treatment is suitable for the patient before prescribing. The patient must collect the treatment from one of our Superdrug Pharmacies, where our pharmacists will provide further advice and guidance, where needed,” they added. 

A spokesperson for LloydsPharmacy Online Doctor said Wegovy would be incorporated into the options included in its GP-led weight loss service when it was medically appropriate.

“Ongoing patient supervision and support for making healthier lifestyle choices are part of the LloydsPharmacy Online Doctor service,” they explained.

Boots offers a free ten-week weight loss programme regardless of whether treatment had been prescribed in addition to other support.

A spokesperson for Boots said: “Patients are required to complete an online consultation, which is reviewed by one of the Boots Online Doctor clinicians to determine if treatment is appropriate.

“Those who are prescribed treatment will receive follow up support from the team and can access advice and support from our pharmacy teams in stores.”

Last updated
The Pharmaceutical Journal, PJ, April 2023, Vol 310, No 7972;310(7972)::DOI:10.1211/PJ.2023.1.181029

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