How Are Weight Loss Medications Covered Globally?

We’ve been following the developments in the realm of GLP-1 agonists for a while now, including their potential to treat various conditions, risks, and availability. Let’s take a quick look at the recent headlines.

France is the latest European nation to decide against covering weight loss medications through its national insurance program. While the anti-obesity drug Wegovy is now available in the country, the French government is not offering enthusiastic support for it.

Novo Nordisk, the Danish pharmaceutical company that also manufactures the popular diabetes drug Ozempic, announced that Wegovy is now on sale in France for individuals struggling with obesity. According to a company representative, 10,000 people in France have already accessed the drug through an early access program.

Wegovy is expected to cost patients between €270 and €330 per month, but France’s national health insurance won’t cover the cost, meaning users will need to pay out-of-pocket. The drug is recommended only as a secondary option for those whose weight loss efforts through diet and exercise have failed.

Additionally, France’s drug safety agency mandates that initial prescriptions for Wegovy must come from an obesity specialist to prevent misuse, such as by individuals without weight-related health problems who may seek it for cosmetic purposes.

Elsewhere in Europe

Despite the widespread popularity of these anti-obesity drugs, which are predicted to generate global sales of $131 billion (€117.4 billion) by 2028, there have been shortages in the European Union since 2022. However, some experts, such as Dr. Jens-Christian Holm from Denmark’s University of Copenhagen, remain skeptical.

Dr. Holm said that the medications are “not the Holy Grail,” adding:

There are problems there. They cost a lot of money. There are side effects, and they are not working when you stop using them.

France is not alone in its cautious stance. For example, Germany’s national health system is prohibited by a 1980s law from covering drugs aimed at “lifestyle” conditions like obesity, smoking cessation, or hair loss. Therefore, while Wegovy has been available in Germany since 2023, only privately insured patients or those who pay out-of-pocket can access it, with the highest dose costing €302 per month.

In Denmark, where Novo Nordisk is based, the drug is also not typically covered. The Danish health authority has estimated that it would cost around 6 million Danish kroner (€805,000) to prevent a single cardiovascular event, a major factor in its decision not to cover the medication.

Meanwhile, in the United Kingdom, the health service recommends that Wegovy be used for a maximum of two years, refusing to fund longer-term use due to concerns about its cost-effectiveness. Given that many patients regain weight after stopping the medication, there is an ongoing debate among researchers, policymakers, and pharmaceutical companies about extending this usage period.

Wegovy is also available in other countries such as Norway, Spain, Switzerland, Italy, Iceland (where usage “increased by more than twenty-fold in five years,”) Australia, Brazil, Canada, Japan, the U.S., and the UAE, with further international launches planned.

Some nations are waiting to observe the effects of the drug before introducing it. For instance, while Wegovy is not yet available in the Netherlands, Dutch officials are already wary of the potential financial strain. Last year, Novo Nordisk requested that Wegovy be included in the Netherlands’ basic health insurance program. However, a government advisory panel expressed concerns in July about the drug’s long-term effects and the potential €1.3 billion annual cost, deeming it “socially irresponsible.”

These financial concerns might shift in the future, as Novo Nordisk has indicated that it could offer flexible pricing to encourage broader adoption of the drug. Additionally, new medications entering the market in the coming years could help reduce prices.

A Novo Nordisk spokesperson told Euronews Health that the company is continuously exploring ways to collaborate with healthcare systems to make its products more accessible, particularly for patients with significant unmet needs.

The U.S.: cost vs. benefits

Also in recent news, according to the U.S. Congressional Budget Office (CBO), the cost of paying for obesity drugs would be greater than the economic benefits. The CBO estimates that Medicare would spend $35 billion more on obesity drugs from 2026 to 2034, but the savings from improved health would be small.

Here are some details from the CBO’s analysis:

  • The CBO estimates that the federal government would pay an average of $5,600 per user in 2026, and $4,300 per user by 2034.
  • The CBO estimates that the savings from improved health would be less than $50 million in 2026, and increase to $1 billion in 2034.
  • The CBO projects that expanded use of obesity drugs would improve beneficiaries’ health, mainly by reducing the incidence of obesity-related chronic diseases.
  • The CBO continues to monitor trends in the use of obesity drugs, including their prices, effects on health, and coverage by insurance plans.

Your responses and feedback are welcome!

Source: “France won’t pay for weight loss drug Wegovy. What about other European countries?,” EuroNews Health, 11/10/24
Source: “Iceland Sees Sharp Rise in Use of Weight-Management Medications,” Iceland Review, 10/9/24
Source: “How Would Authorizing Medicare to Cover Anti-Obesity Medications Affect the Federal Budget?,” CBO.gov, October 2024
Image by Jakub Żerdzicki on Unsplash

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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