1 Recommendations

Can be used in the NHS with evidence generation

1.1 Five digital weight-management technologies can be used in the NHS while more evidence is generated, to deliver specialist weight-management services for adults who are eligible for weight-management medicine. The technologies are:

  • Gro Health W8Buddy (DDM Health), for prescribing and monitoring weight-management medicine

  • Liva (Liva), for tracking weight-management medicine

  • Oviva (Oviva), for prescribing and monitoring weight-management medicine

  • Roczen (Reset Health), for prescribing and monitoring weight-management medicine

  • Second Nature (Second Nature), for prescribing and monitoring weight-management medicine.

    These technologies can only be used once they have appropriate Digital Technology Assessment Criteria (DTAC) approval.

1.2 The companies must confirm that agreements are in place to generate the evidence (as outlined in NICE's evidence generation plan) and contact NICE annually to confirm that evidence is being generated and analysed as planned. NICE may withdraw the guidance if these conditions are not met.

1.3 At the end of the evidence generation period (4 years), the companies should submit the evidence to NICE in a form that can be used for decision making. NICE will review the evidence and assess if the technologies can be routinely adopted in the NHS.

Can only be used in research

1.4 More research is needed on using the following digital weight-management technologies:

  • CheqUp (CheqUp Health)

  • Juniper (Juniper Technologies UK)

  • Wellbeing Way (Xyla Health and Wellbeing).

1.5 Access to the technologies in section 1.4 should be through company, research, or non-core NHS funding, and clinical and financial risks should be appropriately managed.

Evidence generation and research

1.6 More evidence generation and research are needed on:

  • change in weight

  • adherence and completion rates, including reasons for stopping a programme

  • how the technologies monitor and report adverse events

  • health-related quality-of-life and psychological outcomes

  • impact on resource use, including the number and type of healthcare appointments and cost of the medicine.

    More information will be included in the evidence generation plan.

Potential benefits of use in the NHS with evidence generation

  • Unmet need: Digital weight-management technologies are an option to deliver specialist weight-management services. They provide weight-management programmes that prescribe or monitor treatment with weight-management medicine. They can be used for adults who are eligible for weight-management medicine after referral and clinical assessment. They will particularly benefit people who do not have access to specialist weight-management services in their area or who are on a waiting list, so are not currently supported by a specialist weight-management service. Weight-management medicine can only be accessed alongside a specialist weight-management service, so by providing these services, these technologies may also improve access to medicine.

  • Clinical benefit: Early evidence suggests that weight loss with the technologies is similar at 2 years, compared with face-to-face specialist weight-management services.

  • Resources: The technologies may reduce the demand for face-to-face specialist weight-management services. This may release resources and increase access or reduce waiting times.

  • Access: The technologies may provide more flexible access to services for people who are unable to travel or who prefer to access services remotely.

Managing the risk of use in the NHS with evidence generation

  • Prescribing: Weight-management medicine that is prescribed through the technologies should only be used in line with NICE's technology appraisal guidance for overweight and obesity and the British National Formulary (BNF)'s prescribing information for drugs for obesity. Prescribing must be done by a suitably qualified healthcare professional. When prescribing weight-management medicine remotely through a technology, healthcare professionals should follow the General Medical Council's remote prescribing high level principles.

  • Clinical assessment: A healthcare professional should do a referral and full clinical assessment before offering access to treatments through these technologies, to make sure the technologies are suitable. Some people may choose not to use a digital service and may prefer another treatment option. Everyone has the right to make informed decisions about their care.

  • Multidisciplinary support: The technologies provide support from a multidisciplinary team (MDT) of qualified healthcare professionals. This must include psychological support and monitoring to reduce the risk of harm, including from disordered eating.

  • Equality: Some people are less comfortable or skilled in using digital technology, or may have limited access to equipment and the internet. These people may be less able to benefit from the technologies and may need additional support or prefer a different treatment option. Some people may need additional support because of a visual, hearing or cognitive impairment, reduced manual dexterity, a learning disability or being unable to read English or understand health-related information. Autistic people may also find the technologies unsuitable or may need additional support. The technologies may not be suitable for some people, even with additional support.

  • Costs: Early results from the economic modelling show that the technologies could be cost effective. This guidance will be reviewed within 4 years and the recommendations may change. Take this into account when negotiating the length of contracts and licence costs.

The evidence generation plan gives further information on the prioritised evidence gaps and outcomes, ongoing studies and potential real-world data sources. It includes how the evidence gaps could be resolved through real-world evidence studies.

  • National Institute for Health and Care Excellence (NICE)