Access to groundbreaking anti-obesity drugs is to be strictly controlled due to “unprecedented” demand, according to the State’s adviser on drug cost-effectiveness.
More than 2,600 people have applied to use Saxenda, the first of the new drugs to be made available to public patients, since January, but half of these applications were refused, Prof Michael Barry told The Irish Times.
The State will pay for the drug, which costs patients about €250 a month, only when they have a body-mass index of 35 or over, pre-diabetes and evidence of cardiovascular disease. Under a controlled access scheme treatment is stopped if the patient does not lose more than 5 per cent of their body weight after 12 weeks.
“The level of interest in this drug is unprecedented, with prescribing up 42 per cent in just over three months,” said Prof Barry, clinical director of the National Centre for Pharmacoeconomics. The State was anticipating a five-year budgetary impact of €10 million, he says, but it will now spend €5 million to €10 million on Saxenda in this year alone.
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He said the “dramatic uptick” in demand for the drug “will be nothing” compared to the demand for Wegovy, which can result in even greater weight loss. “The issue will be whether we can afford this or not in view of what we’re already seeing with Saxenda.”
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The new injectable anti-obesity drugs, which work by curbing patients’ appetite, need to be taken for life. Given more than 60 per cent of the population is overweight or obese, their potential cost is prompting concern in the health service.
“We’re going to see a huge increase in the number of patients seeking these treatments and, obviously, an associated increase in costs,” Prof Barry said. “These weight-loss drugs will be amongst the biggest challenges we face in the coming years in relation to affordability.”
As a result, he said, it is likely that access to future drugs, expected to be even more effective in helping patients shed excess weight, will be managed through access programmes similar to that used for Saxenda.
Endocrinologist Prof Francis Finucane described access to treatments as a problem. In his specialist clinic in Galway patients’ “almost never” obtain State funding despite 70 per cent of them being on medical cards and going through a “bureaucratic” applications process. Ultimately most have to pay for the drugs themselves.
“Patients with obesity in Ireland who should have access to these safe, effective drugs are instead often stuck between the rock and the hard place of corporate prioritisation of profit and a health system that still doesn’t care about the disease of obesity,” Prof Finucane said.
Another drug, Ozempic, is available in Ireland to treat diabetes but can be prescribed off-licence for weight loss. Prof Barry said he was aware of the off-licence use of Ozempic for treating obesity but it was “not something we can support”.
“Why should we ask our patients to pay twice as much for Saxenda, which is over twice the price of Ozempic and isn’t as good?” asked Prof Finucane.
Questioning whether the non-availability was driven by commercial rather than clinical factors, he added: “Watching patients’ health deteriorate when they run out of Ozempic that’s been prescribed instead in beauty clinics has been difficult to stomach.”
Novo Nordisk, the Danish manufacturer of all three drugs, said Ozempic is licensed by the European Medicines Agency for the treatment of diabetes only. “Novo Nordisk faces the same supply challenges affecting the broader pharmaceutical sector and wider economic activity,” a spokesman added.
