NICE has today recommended a new treatment option for those adults managing obesity and non-diabetic hyperglycaemia alongside a reduced-calorie diet and increased physical activity.
Liraglutide (also known as Saxenda and made by Novo Nordisk) will be offered to adults with non-diabetic hyperglycaemia who have a body mass index (BMI) of at least 35 kg per m2 and have a high risk of cardiovascular disease because of risk factors such as high blood pressure or high cholesterol levels.
The pre-filled injection pens will be prescribed in secondary care, by a specialist multidisciplinary tier 3 weight management service. People who are referred to a tier 3 service will normally have been offered weight management interventions in a local, intensive lifestyle-change programme (such as the NHS diabetes prevention programme) first.
All eligibility criteria must be met for treatment to be offered.
The draft guidance says treatment with liraglutide should be discontinued if at least 5% body weight has not been lost after 12 weeks on the full dose. Treatment for all patients will stop after two years.
NICE had previously not been able to recommend the treatment because the cost-effectiveness estimate was highly uncertain and potentially much higher than NICE considers a cost-effective use of NHS resources. However, the company has now agreed a confidential discount with NHS England and NHS Improvement, which reduces this uncertainty.
Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: “There is a real need for more treatment options for obese adults with non-diabetic hyperglycaemia who have a high risk of experiencing the adverse consequences of obesity, such as type 2 diabetes and cardiovascular disease.
“Our independent committee was presented with clinical evidence which showed that people lose more weight with liraglutide plus lifestyle measures than with lifestyle measures alone. Liraglutide may also delay the development of type 2 diabetes and cardiovascular disease and this is the main benefit of treatment.
“After NICE was previously unable to recommend liraglutide, we are pleased the company was able to agree a confidential discount which allowed the committee to recommend it.”
This guidance covers the management of obesity and non-diabetic hyperglycaemia in a specialist weight management (tier 3) service.
NICE already recommends another brand of liraglutide (Victoza) which is licensed for insufficiently controlled type 2 diabetes mellitus, a severe form of diabetes in which the body cannot use glucose.
Consultees now have 15 days to appeal against the recommendations in the final draft guidance.