Professor Urges Careful Consideration for Wegovy Funding

A leading health academic says Pharmac should not consider wide-scale funding of so-called "miracle" weight-loss drugs until the country has a solid approach to treating obesity. University of Otago Prof Jim Mann, who is co-director of the Edgar Diabetes and Obesity Research Centre, said weight loss medication such as Wegovy should not have a wide roll-out in the current environment, where it was estimated that one-third of the adult population was obese. "I think that there are some people who would almost certainly benefit and Pharmac should consider that. "They are people with heart disease and heart failure, as well as some groups of people with diabetes. "But the really big point that I would make is that this whole thing should be seen in context of an overall national strategy towards obesity, which is one of our biggest health issues." Prof Mann said while the new array of drugs such as Wegovy had been branded as "miracles" for their weight-loss effectiveness, it was still early days in regard to potential side-effects. "As far as this drug is concerned, it needs nutritional support to be built in, because the minute you stop taking them, you’ll gain weight if you haven’t learned to have better eating habits. "I really think that this thing needs to be looked at as part of a big picture, not just should we fund Wegovy or shouldn’t we fund Wegovy." Absolutely nothing in obesity was a "magic bullet", he said. There were also serious concerns about weight regain once patients were weaned off the drug. "I feel very strongly that nobody should be put into those drugs without detailed dietary counselling. "The problem that we have in this country now is that we don’t have the opportunity for adequate counselling in primary care. "We don’t even have adequate dietary counselling. "We don’t even have it in hospital, never mind primary care." Pharmac director of advice and assessment David Hughes said guidance was expected to be published later this month. In Australia, Health Minister Mark Butler committed to subsidising the drug for patients with an established cardiovascular disease and a BMI of 35 or higher. At the moment, Wegovy costs $459.99 per month in New Zealand. But some healthy scepticism was required, Prof Mann said. "I would be supportive of prescribing the drug for a limited group of people who are at particularly high risk of the consequences of obesity. "But if we are saying that these drugs should be used like blood pressure drugs or diabetes drugs or heart disease and cholesterol drugs, I mean, we’ve got years and years and years of experience with those drugs. "We don’t have years and years and years of experience with these new drugs." Prof Mann said he and others desperately needed to update the obesity treatment guidelines with the help of the Ministry of Health, as the strategy had been dormant for more than a decade. — Additional reporting by RNZ