Thousands of people living with obesity are set to benefit from a
new drug which has helped those using it to reduce their weight
by more than 10 per cent.
NICE has today (Tuesday 8 February 2022) issued draft guidance
recommending semaglutide (also known as Wegovy and made by Novo
Nordisk) to adults with at least one weight-related condition and
a body mass index (BMI) of at least 35 kg/m2, and
exceptionally, to people with a BMI of 30.0 kg/m2 to
34.9 kg/m2.
Semaglutide can only be prescribed as part of a specialist weight
management service with multidisciplinary input (such as a tier 3
weight management programme or tier 4 specialist obesity services
including surgery service) and for a maximum of two years.
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.
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 2019 Health Survey for
England estimated 28% of adults in England were obese 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.
Helen Knight, programme director in the centre for health
technology evaluation at NICE, said: “We know that
management of overweight and obesity is one of the biggest
challenges our health service is facing with nearly two thirds of
adults either overweight or obese. It is a lifelong condition
that needs medical intervention, has psychological and physical
effects, and can affect quality of life.
“But in recent years NICE has been able to recommend a new line
of pharmaceutical treatments which have shown that those people
using them, alongside changes to their diet and exercise, have
been able to reduce their weight.”
A commercial agreement has been signed between NHS England and
the company that allows the NHS to purchase the drug below its
list price. The details of the arrangement are commercial in
confidence.
NICE’s independent appraisal committee has recommended that
semaglutide can be offered as an option for weight management,
alongside a reduced-calorie diet and increased physical activity
in adults, only if:
- they have at least one weight-related comorbidity and:
- a BMI at least 35.0 kg/m2, or
- exceptionally, a BMI of 30.0 kg/m2 to 34.9 kg/m2 if they are
referred to tier 3 services based on the criteria in NICE’s
clinical guideline on obesity:
identification, assessment and management.
A lower BMI threshold (usually reduced by 2.5 kg/m2) has been
recommended for people from south Asian, Chinese, and Black
African or Caribbean family backgrounds, following
recommendations in NICE’s guideline on preventing
ill health and premature death in black, Asian and other minority
ethnic groups.
The recommendations specify that semaglutide can only be offered
in a specialist weight management service and can only be used
for a maximum of two years.
A consultation has now begun on the committee’s recommendation
and comments can be made via nice.org.uk until 5pm on
Tuesday 1 March 2022.
