With two thirds of adults in England now classified as overweight, external, and 30% living with obesity, external, the government is keen to see more people follow David’s example. But the question is, who pays for it?
Both Mounjaro and Wegovy are available on the NHS but the criteria is currently very strict.
In theory under NICE guidelines (the body which approves drugs for NHS use) it can be given to people with a BMI of 35 or over and one related health condition (for Mounjaro) or a BMI of 30 and over with one related health condition (for Wegovy).
The criteria for patients from some ethnic minorities is slightly lower as NICE judged that they were at higher risk for weight-related health issues.
NICE calculated that for Mounjaro alone 3.4 million people would qualify under these criteria, external. Modelling by the NHS concluded that this would cost billions of pounds a year with a high of £3.9bn at the end of the second year, external.
The NHS decided that this cost was unsustainable. So instead they decided to restrict it initially to patients with a BMI of 40 and four related health conditions from a list of five (37.5 BMI for some groups).
The bar will decrease gradually over the next 12 years starting in June when the BMI requirement will go down to 35 but patients will still need the four health conditions.
Some obesity experts worry that this means many people who are severely overweight are unable to access it.
Dr Nicki Mazey is a GP partner at Brownlow Health in Liverpool who specialises in obesity.
“There is a cohort of patients who I feel would absolutely benefit from it but they don’t quite meet the criteria and I am not allowed to prescribe it,” she said.
“I’ve had patients with BMIs over 100 but they don’t have the four out of five co-morbidities.”
“At that point they’ll ask, ‘What are my options? Where can I get it or shall I go privately?’. I’d never had that situation [before] but now I’m having it regularly.”
Dr Mazey worries that the high cost of private prescriptions is driving some towards the unregulated, and often dangerous, black market.
Private prescriptions can cost more than £300 a month. Delivery driver David says he spends £250 on Wegovy after switching from Mounjaro, which cost him more.
He says he has had to cut back on other expenses and compares it to others paying for a car.
“You’ve got to sacrifice certain things.
“If you’ve got the money and you were in my shoes you’d do it. For people who haven’t got the money, I do feel sorry for them.”
