Semaglutide for reducing the risk of major adverse cardiovascular events in people with cardiovascular disease and overweight or obesity

  • Technology appraisal guidance
  • TA1152
  • Published: 
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1 Recommendation

1.1

Semaglutide (up to a maintenance dose of 2.4 mg once weekly) can be used, within its marketing authorisation, alongside a reduced-calorie diet and increased physical activity, as an option for reducing the risk of a major adverse cardiovascular event (that is, cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adults with both:

  • established cardiovascular disease (CVD), defined as at least 1 of the following:

    • previous myocardial infarction

    • previous ischaemic or haemorrhagic stroke

    • symptomatic peripheral arterial disease (they have intermittent claudication with an ankle-brachial index of less than 0.85 at rest, or have had a peripheral arterial revascularisation procedure or an amputation because of atherosclerotic disease), and

  • a body mass index (BMI) of at least 27 kg/m2.

    Semaglutide can only be used if the company provides it according to the commercial arrangement.

What this means in practice

Semaglutide must be funded in the NHS in England for the condition and population in the recommendation, if it is considered the most suitable treatment option. Semaglutide must be funded in England within 90 days of final publication of this guidance. This guidance does not specify which setting semaglutide should be used in.

Further information on the secondary prevention of cardiovascular events is available in:

There is enough evidence to show that semaglutide provides benefits and value for money, so it can be used routinely across the NHS in this population.

NICE has produced tools and resources to support the implementation of this guidance.

Why this recommendation was made

Standard care for established CVD in people with a BMI of at least 27 kg/m2 includes lifestyle changes and medicines aimed at reducing the risk of a major adverse cardiovascular event.

Clinical trial evidence shows that semaglutide plus standard care reduces the risk of a major adverse cardiovascular event compared with placebo plus standard care in this population.

The cost-effectiveness estimates for semaglutide are within the range that NICE considers an acceptable use of NHS resources. So, it can be used.