The Revolutionary Way to Get Weight-Loss Medications: App-Based Prescriptions in the UKDecember 16, 2023
The UK has taken innovative steps in facilitating weight-loss medication prescriptions by endorsing them through digital applications, in anticipation of the introduction of the weight-loss drug, Wegovy.
The National Institute for Health and Care Excellence (NICE) in the UK has provided a list of four digital platforms, namely Liva, Oviva, Roczen, and Second Nature. These platforms serve as a bridge between patients and National Health Service (NHS) professionals who offer guidance and therapy.
These digital interventions are intended to support those who might not have immediate access to specialist weight-management services, or those placed on a waiting list without the backing of a specialised program. With the additional advantage of potentially easing the load on in-person specialist services, these innovations might also curtail waiting durations.
The NHS has been grappling with heightened waiting periods, with the figures reaching nearly 7.6 million in June, a situation worsened by the COVID-19 outbreak. Alarmingly, patients in specific regions are enduring up to a month’s wait to see a general practitioner.
The 2021 health assessment indicates that approximately 30% of adults in England are obese, with another 38% being overweight. This elevates the risk of multiple health concerns, such as diabetes, heart-related issues, and even cancer.
By making weight-management therapies accessible via apps, NICE believes this could amplify the availability of such treatments.
The Rising Demand for Wegovy
Following its approval, the craving for Novo Nordisk’s Wegovy has skyrocketed, with social media influencers significantly boosting its demand. However, only four nations – Denmark, Norway, Germany, and the US – have witnessed its launch. Due to production constraints, the company has put a cap on the number of new patients. Individuals on Wegovy are subjected to weekly injections lasting up to two years.
Novo’s portfolio for weight loss includes Saxenda and Wegovy. Clinical trials reveal that Saxenda resulted in a weight reduction of 5-10% over 56 weeks, whereas Wegovy led to about 15% weight loss across 68 weeks. The latter remains unavailable in the UK.
This year, NICE introduced a guideline which suggests Wegovy for those with a specific BMI (generally 30kg/m2 or higher) accompanied by at least one weight-related health concern. The recommendation further extends to those with prediabetes or type 2 diabetes for weight management within specialised services, contingent on individual circumstances.
To address the obesity crisis, the Department of Health launched a two-year initiative on 7 June 2023. The project will investigate the potential of prescribing Wegovy outside the confines of specialist weight management establishments, predominantly based in hospitals.
Resistance in Practice
Although NICE has given its approval for Wegovy, signaling a progressive shift in medical endorsements, in the intricate labyrinth of healthcare, an approval doesn’t always translate into widespread adoption. A noticeable reticence lingers among some medical professionals when it comes to prescribing Wegovy, especially if it’s not directly linked to a diabetes-related condition.
The reluctance might stem from several reasons. First, some physicians might be grounded in a traditional approach, favoring established treatments over newer alternatives unless their efficacy is proven beyond doubt. Second, the potential side effects or long-term impacts of Wegovy, as with any new drug, might still be under study, making some doctors cautious about prescribing it for conditions outside of its primary indication. There might also be concerns about the cost-effectiveness of the drug or potential pressures from insurance companies.
The discrepancy between NICE’s endorsement and the reluctance of some doctors to prescribe the drug accentuates a significant chasm in the medical field: the gap between policy and practice. Policy changes, while essential, often require a parallel shift in mindset at the grassroots level – amongst practitioners, patients, and the wider public. Overcoming this resistance is critical not just for the adoption of Wegovy but for the broader evolution of healthcare practices. As medical science advances, it will be crucial for policy and practice to align more closely, ensuring that patients benefit from the latest discoveries and treatment options.
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