Semaglutide (Wegovy®) for managing overweight and obesity

The Lincolnshire ICB has released the following statement regarding prescribing Wegovy for weight loss

Semaglutide (Wegovy®) for managing overweight and obesity – Position Statement

Background information

Approach to weight loss management for obesity is multifactorial and should include dietary advice, weight loss targets, physical activity programmes, behavioural interventions and psychological support and pharmacological therapy such as semaglutide, a GLP-1 receptor agonists.

The National Institute for Health and Care Excellence (NICE) Technology appraisal guidance [TA875] Published: 08 March 2023 recommended the use of semaglutide (Wegovy®) alongside a reduced-calorie diet and increased physical activity to adults who have at least one weight-related comorbidity and a body mass index (BMI) of at least 30kg/m2 and over for managing overweight and obesity in an NHS specialist weight management service.

At present the product semaglutide (Wegovy®) has not been launched in the UK and currently there is no information regarding the product such as price or who will be able to prescribe. No date has been confirmed by the company Novo Nordisk as to when the product or information will be available. Semaglutide (Wegovy®) for weight loss will only be available to patients that meet the eligibility criteria outlined by NICE through a specialist weight management service. semaglutide (Wegovy®) was added to the formulary as a NICE TA875, but not given a traffic light classification until it becomes available in the UK and there is clarification how it will be used.

However, given the ongoing national shortage of GLP-1 receptor agonists caused by an increase in demand for these products for licensed and off-label indications, a National Patient Safety Alert – DHSC issued on 18-Jul-2023 requests that the off-label use of these agents for the management of obesity is strongly discouraged. All existing stock must be conserved for use in patients with diabetes because of the serious clinical implications in the management of patients with type 2 diabetes that these shortages pose.

The ICB DOES NOT support the use of GLP-1 receptor agonists for weight loss until there is clear guidance from NHS England and we are over the supply issue. In addition, we will put in place a clinically led pathway BEFORE this is authorised for use. Eligible people with T2DM who would like support with weight management should be signposted to available locally and nationally available weight management programmes.

Useful Resources

NICE Technology Appraisal Guidance [TA875] https://www.nice.org.uk/guidance/ta875

MHRA Central Alerting System: National Patient Safety Alert (NatPSA)

https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103235

Primary Care Diabetes Society PCDS_ABCD-GLP-1-RA-shortage_20230628.pdf (diabetesonthenet.com)

Healthier You. NHS Diabetes Prevention Programme – clinicians to complete the referral form embedded in your clinical system and send via email to [email protected]