NHS Expands Access to Weight Loss Injections for Diabetics

Thousands more individuals in the United Kingdom could gain access to weight loss injections through the National Health Service (NHS) as new guidelines are proposed to enhance diabetes care. The National Institute for Health and Care Excellence (NICE) intends to relax prescription rules, allowing people with type 2 diabetes to receive medications like Ozempic and other diabetes drugs at earlier stages of treatment.

Currently, the NHS follows a one-size-fits-all approach, often delaying the prescription of these advanced medications. The new draft guidance suggests a shift towards personalized care, focusing on early intervention to mitigate complications such as heart attacks and heart failure. According to NICE, this change could potentially save almost 22,000 lives.

Professor Jonathan Benger, deputy chief executive and chief medical officer at NICE, emphasized that the proposed adjustments would enable healthcare providers to offer medications that are appropriate for individual patients more promptly. The new guidelines encourage doctors to prescribe glucagon-like peptide-1 (GLP-1) receptor agonists, including liraglutide and semaglutide, to diabetes patients with additional health concerns like heart disease or obesity.

Patients diagnosed with type 2 diabetes would be considered for these medications at the point of diagnosis, rather than after trying other treatments. NICE estimates that approximately 754,000 patients suffering from cardiovascular disease or early-onset diabetes could benefit from these changes.

The guidelines specifically recommend that patients diagnosed with heart disease, heart failure, or early-onset type 2 diabetes—defined as being diagnosed before the age of 40—should have access to these weight loss injections. Those with a body mass index (BMI) over 35 who have not achieved adequate blood sugar control with other medications within three months would also qualify for these treatments.

In addition to the changes regarding GLP-1 medications, NICE is advocating for newer diabetes drugs known as SGLT-2 inhibitors, such as canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin, to be considered first-line treatment options. These medications work by aiding the kidneys in removing glucose from the bloodstream, thereby lowering blood sugar levels.

Despite their effectiveness, analysis by NICE has revealed that SGLT-2 inhibitors are often under-prescribed, particularly among women, older individuals, and black patients. Professor Benger noted the necessity of addressing these prescription gaps to ensure equitable access to effective treatments.

The new guidelines also stipulate that patients who cannot tolerate metformin, the standard first-choice medication for type 2 diabetes, should begin treatment with an SGLT-2 inhibitor alone. This recommendation stems from evidence indicating that these drugs not only manage blood sugar but also provide protective benefits for the heart and kidneys.

While around 2.3 million individuals with type 2 diabetes are expected to be eligible for SGLT-2 inhibitors under the updated guidelines, implementation will not occur immediately. A public consultation on the NICE guidelines is currently open and will conclude on October 2, 2023.

Douglas Twenefour, head of clinical at Diabetes UK, hailed the announcement as a significant advancement in diabetes treatment, stating, “Boosting access to newer treatments will be transformative for people with type 2 diabetes.”

As the demand for weight loss jabs surges, patients are keen to secure the medications before anticipated price increases take effect. Recently, drug maker Eli Lilly announced a forthcoming price hike for its weight loss jab, Mounjaro, set to nearly double in UK private clinics. In contrast, Novo Nordisk, the manufacturer of Wegovy, has indicated it will not raise prices.

This evolving landscape of diabetes treatment reflects a broader commitment to improving health outcomes for millions of individuals living with type 2 diabetes. By prioritizing early intervention and personalized care, the NHS aims to enhance the quality of life and long-term health for its patients.