2 The technologies

2.1 Digital weight-management technologies can be used to deliver specialist weight-management services. They can be accessed online or through an app, and provide a multidisciplinary programme and support from the service's multidisciplinary team (MDT) of healthcare professionals. Some technologies offer weight-management medicine prescribing and medicine reviews with a prescribing clinician, alongside regular reviews with other members of the service's MDT. Other technologies collect and share medicine adherence data with the person's NHS team, to support the NHS team with prescribing weight-management medicine. The frequency of reviews may vary depending on the technology, user preference and stage of the programme. NICE has assessed 8 technologies that can deliver specialist weight-management services. The criteria for including technologies in this early value assessment (EVA) and further details of each technology are in section 2.2, table 2 and appendix E of the assessment report, and in the assessment report addendum on the NICE website. The technologies are:

  • CheqUp (CheqUp Health): this is an online platform that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. CheqUp does not have a CE or UKCA mark because it is not classed as a medical device.

  • Gro Health W8Buddy (DDM Health): this is an online platform that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Gro Health W8Buddy is a CE‑marked class I medical device.

  • Juniper (Juniper Technologies UK): this is an app that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Juniper does not have a CE or UKCA mark because the company states it is not classed as a medical device.

  • Liva (Liva): this is an online platform that provides a multidisciplinary weight-management programme and weight-management medicine tracking. It does not include weight-management medicine prescribing. Liva is a CE‑marked class I medical device indicated for type 2 diabetes.

  • Oviva (Oviva): this is an app that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Oviva is a CE‑marked class IIa medical device.

  • Roczen (Reset Health): this is an online platform that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Roczen does not have a CE or UKCA mark because it is not classed as a medical device.

  • Second Nature (Second Nature): this is an app that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Second Nature does not have a CE or UKCA mark because it is not classed as a medical device.

  • Wellbeing Way (Xyla Health and Wellbeing): this is an online platform that provides a multidisciplinary weight-management programme and weight-management medicine prescribing. Wellbeing Way does not have a CE or UKCA mark because it is not classed as a medical device.

Care pathway

2.2 Semaglutide for weight management must be used within a specialist weight-management service that provides multidisciplinary management of overweight or obesity, including but not limited to tier 3 and tier 4 services (see NICE's technology appraisal guidance on semaglutide for managing overweight and obesity). Liraglutide for managing overweight and obesity must be prescribed in secondary care by a specialist multidisciplinary tier 3 weight-management service (see NICE's technology appraisal guidance on liraglutide for managing overweight and obesity).

2.3 Tier 3 and 4 specialist weight-management services for people with overweight and obesity are defined in NHS England's guidance for Clinical Commissioning Groups (CCGs): Service Specification Guidance for Obesity Surgery (2016) and NICE's guideline on obesity: identification, assessment and management. A typical MDT should include an obesity doctor, specialist nurse, specialist dietitian, psychologist and physiotherapist. It should also have access to healthcare professionals with expertise in surgical assessments. The intensity, frequency and variety of support from an MDT of healthcare professionals varies between NHS specialist weight-management services. It may be offered in person, remotely by telephone or video call, or as a combination of in-person and remote support. Most programmes offered by these services take between 12 and 24 months to complete, but some may only take 6 months. The criteria for accessing these services may also vary depending on the geographical area and local funding.

The comparator

2.4 The comparator is standard care to manage treatment with weight-management medicine for adults who are eligible for weight-management medicine. Standard care includes specialist weight-management programmes (including, but not limited to tier 3 and 4 services). They may be delivered face to face, remotely or as a combination of remote and face-to-face support.

2.5 No or delayed treatment is also a relevant comparator. Some people are on waiting lists to access services or have no access at all.

  • National Institute for Health and Care Excellence (NICE)