NICE recommended weight-loss drug to be made available in specialist NHS services

Thousands of people will soon be able to be prescribed a drug to help them lose weight as part of their treatment in an NHS specialist weight management service.

The drug can help people using it to reduce their weight by over 10 per cent when used with support of a multidisciplinary team. These professionals are experts on coaching people on lifestyle interventions and will also monitor the drug’s potential side-effects.

NICE has recommended the use of semaglutide, also called Wegovy, alongside a reduced-calorie diet and increased physical activity to adults who have at least 1 weight-related comorbidity and a body mass index (BMI) of at least 35kg/m2.

People with an BMI of between 30-34.9 kg/m2, with 1 weight-related comorbidity who are eligible for referral to specialist weight management services could also be prescribed the drug.

A weight-related comorbidity could be one of: dysglycaemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia (in which disturbances in fat metabolism lead to changes in the concentrations of lipids in the blood), obstructive sleep apnoea or cardiovascular disease

It will be available to NHS patients soon when the launch of the drug in England is confirmed by manufacturer Novo Nordisk.

Patients inject themselves once a week with pens pre-filled with semaglutide. The drug suppresses appetite by mimicking the hormone glucagon-like peptide-1 (GLP-1), which is released after eating. It makes people using it feel full, thereby resulting in people eating less and reducing their overall calorie intake.

The publication of final guidance today (Wednesday 8 March 2023) requires the NHS in England to implement the NICE recommendations within 3 months of the product becoming commercially available.

Helen Knight, director of medicines evaluation at NICE, said: “For some people losing weight is a real challenge which is why a medicine like semaglutide is a welcome option.

“It won’t be available to everyone. Our committee has made specific recommendations to ensure it remains value for money for the taxpayer, and it can only be used for a maximum of two years.

“We are pleased to finally publish our final guidance on semaglutide which will mean some people will be able to access this much talked about drug on the NHS.”

Semaglutide can only be prescribed for a maximum of two years within a specialist weight management service providing multidisciplinary management of overweight or obesity (including but not limited to services in tiers 3 and 4). This recommendation mirrors the clinical and financial modelling supplied by the company that people are treated for a maximum of two years in specialist weight management services.

Clinical trial evidence shows that people lose more weight with semaglutide alongside supervised weight loss coaching than with the support alone.

Evidence from the STEP 1 clinical trial, a randomised double-blind trial, showed that participants taking semaglutide lost on average 12% more of their body weight compared with placebo.

During clinical trials patients reported the main side effects were gastrointestinal disorders including nausea, diarrhoea, constipation and vomiting.

The 2019 Health Survey for England estimated 28% of adults in England were living with obesity and a further 36% were overweight. Government estimates indicate that the current costs of obesity in the UK are £6.1 billion to the NHS and £27 billion to wider society.

An independent committee recommended its use in final draft guidance in June 2022, but NICE has been unable to publish final guidance until today because the product had not been scheduled to launch in England.

Semaglutide won’t be available to everyone. Our committee has made specific recommendations to ensure it remains value for money for the taxpayer, and it can only be used for a maximum of two years.

Helen Knight, director of medicines evaluation at NICE