NHS to offer Wegovy to a million more people in England

The NHS in England will make Novo Nordisk's Wegovy available to around 1.2 million people in order to reduce their risk of heart attacks and strokes.

New guidance from reimbursement authority NICE will make weekly Wegovy (semaglutide) injections an option for people who are overweight – with a BMI of 27 or more - and have also previously been diagnosed with a heart attack, a stroke, or peripheral arterial disease.

Wegovy – which is already available via the NHS in England for some people with obesity – will be offered as an additional treatment on top of standard therapy with statins alongside a reduced-calorie diet and increased physical activity.

The decision is based on the results of the SELECT study, which showed that Wegovy reduced the risk of future heart attacks, strokes, and cardiovascular deaths by almost 20% over about three years when given to non-diabetic patients with the aforementioned characteristics, and appeared to be unrelated to how much weight was lost.

NICE's move acknowledges the growing evidence that the effects of GLP-1 agonists like semaglutide extend beyond weight loss, so they should not be restricted only to those who are very overweight.

"Our role is to help practitioners get the best care to people while ensuring value for the taxpayer, and we are confident this rigorous, transparent recommendation strikes the right balance between clinical effectiveness and the best use of limited NHS resources," said Helen Knight, director of medicines evaluation at NICE.

"The evidence from the clinical trial is compelling," she added. "It showed that people taking semaglutide alongside their existing heart medicines were significantly less likely to have another heart attack or stroke."

The decision has been warmly welcomed by clinicians and patient organisations, who have said that lives will be saved by extending the use of Wegovy.

"Today's guidance will no doubt help save lives, as cardiovascular disease is still one of the country's biggest killers," said Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation.

"That's why it's so important that when we get new and effective medicines which prevent cardiovascular disease complications, like semaglutide, that they get to everyone who could benefit as soon as possible."

That sentiment was also voiced by Prof Riyaz Patel, a consultant cardiologist at UCLH and Barts Health NHS Trust, who said another question is how Wegovy will be delivered in practice, and the capacity within the health system to do so.

"We know, for example, that other highly beneficial drugs like [Novartis' Leqvio (inclisiran)] for cholesterol lowering have been variably delivered, leading to significant postcode lotteries," he pointed out.

"ICBs [Integrated Care Boards] must ensure this does not happen with this NICE [guidance], else we risk exacerbating health inequalities when, if anything, this should be a powerful tool to reduce health inequality."