France to patients: Take weight loss drug Wegovy on your own dime

The anti-obesity drug Wegovy is now available in France – but the government isn’t exactly giving it a ringing endorsement.

Danish drugmaker Novo Nordisk, which also makes the blockbuster type 2 diabetes medication Ozempic, said this week that Wegovy will now be sold in France for patients with obesity. Already, 10,000 French people have gotten it through an early-access scheme, a company spokesperson said.

Wegovy is expected to cost patients €270 to €330 per month, but France’s national health insurance programme won’t foot the bill and patients will have to pay on their own. It said the drug should only be used as a second-line treatment if diet and exercise alone aren’t enough to help patients shed weight.

Meanwhile, the French drug safety agency said that people must get their first prescriptions from an obesity medicine specialist to make sure Wegovy isn’t misused for “aesthetic” reasons, for example by people who aren’t overweight and don’t have weight-related health issues.

Weight-loss drugs ‘not the Holy Grail’

Wegovy is one of a new class of weight loss drugs called GLP-1 receptor agonists, which work by suppressing a person’s appetite and have exploded in popularity in recent years.

Health analysts expect global sales of these anti-obesity medications to reach $131 billion (€117.4 billion) by 2028, and shortages have been reported across the European Union since 2022.

But despite their commercial success, the medications are “not the Holy Grail,” Dr Jens-Christian Holm, an associate professor at the University of Copenhagen and head of the Children’s Obesity Clinic at Holbæk University Hospital in Denmark, told Euronews Health.

“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 isn’t the only country taking a cautious approach to the medicines. For example, a 1980s law bans Germany’s national health system from paying for drugs that target “lifestyle” issues like obesity, smoking cessation, hair growth, and erectile dysfunction.

That means that while Novo Nordisk has been selling Wegovy in Germany since 2023, only privately insured patients or those willing to pay out-of-pocket can get it. The highest dose costs €302 per month, a company spokesperson said.

Wegovy also isn’t usually covered in Denmark – Novo Nordisk’s home country – partly because the Danish health authority estimates that it would cost about 6 million Danish kroner (about €805,000) to prevent a single cardiovascular event.

Holm, who believes weight loss drugs should be reserved for people who struggle to manage obesity in other ways, said that many doctors don’t fully understand the drugs and are prescribing them too readily. That can make it harder to get them covered for someone who could really benefit.

“Those who pay the price for this confusion and lack of knowledge are primarily the patients,” Holm said.

Meanwhile, in the United Kingdom, the health service recommends that people take Wegovy for a maximum of two years, and it won’t pay for longer-term use out of concerns over the cost-effectiveness of the drug.

But given that people who stop taking the medicine often gain the weight back, obesity researchers, policymakers, and drug companies have been debating whether that period should be extended.

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Dr Adam Collins, an associate professor of nutrition at the University of Surrey in the UK, said it should be clearer which patients the drugs can benefit – such as people with other health issues like insulin resistance or cardiovascular risk factors – and that doctors need to know how to treat patients after the two-year mark, for example by slowly reducing their dosage or helping them implement other lifestyle changes to keep their weight down.

“Keep [the drug] for those that need it most,” Collins said.

Making products ‘more accessible’

Wegovy is also available in Norway, Spain, Switzerland, Italy, and Iceland, and outside of Europe in Australia, Brazil, Canada, Japan, the United States, and the United Arab Emirates – with more launches on the way, the Novo Nordisk spokesperson said.

Other countries are waiting to see what happens abroad. While Wegovy isn’t yet available in the Netherlands, the Dutch authorities are already skittish about the potential hit to their budget.

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Last year, Novo Nordisk asked for it to be added to the country’s basic health insurance plan – which is mandatory for all residents – but a government advisory group warned in July that there are “major uncertainties” about the drug’s long-term effects and that it could cost the country €1.3 billion per year – a “socially irresponsible” toll.

“Based on the large population that may be eligible for treatment with weight-reducing drugs, including semaglutide, a broader social discussion about the use of these products is without question in order,” the Dutch health care institute said in a notice to health minister Fleur Agema in July.

These budget concerns could change in the future as Novo Nordisk executives have signalled they may offer flexible pricing to convince countries to take up the drug. New medicines are expected to enter the market in the coming years and could also help drive down prices.

“Novo Nordisk is continuously evaluating options with healthcare systems to make our products more accessible to a broader population, especially to those with a high unmet medical need,” a company spokesperson told Euronews Health.

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Meanwhile, the European Medicines Agency (EMA) said this summer that Wegovy can also be used to prevent major cardiovascular problems like heart attacks and stroke among people with obesity.

In clinical trials, semaglutide – the active ingredient in Wegovy – was associated with a 20 per cent reduction in these issues.

The EMA decision could help convince European health agencies to cover Wegovy for cardiovascular problems, not just weight loss – something the German authorities have already said they may do.

As debate rages on about whether to pay for the drugs or not, Holm hopes that obesity will be viewed more like any other medical issue, pointing out that cancer drugs, children’s growth hormones, and some rheumatic treatments are also very expensive.

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“It’s just this cultural thing about obesity [that makes people say] ‘No thank you,’” he said. “It’s really not fair”.