Marking a shift in its approach to treating the global health problem, the World Health Organisation will officially back using weight-loss drugs to treat adult obesity – which affects more than 1bn people worldwide – while calling for strategies to improve access to the treatment in low- and middle-income countries.
More than 70% of obese people live in low and middle-income countries, the World Bank estimates.
Reuters reports that the blockbuster treatments, like Wegovy (Novo Nordisk) and Zepbound (Eli Lilly), launched in the United States and other high-income countries like Germany and Britain, are hugely expensive, and studies suggest people may have to take the drugs for the rest of their lives to keep the weight off.
The recommendations for the drugs, which will be finalised by August or September this year, “will include how and when this class of medication may be integrated as one component of a chronic care model that includes both clinical and lifestyle interventions”, said an agency spokesperson.
Separately, WHO experts will also meet next week to decide whether to include the GLP-1 drugs in the agency’s essential medicines list, both to treat obesity and type 2 diabetes.
The WHO’s list catalogues drugs that should be available in all functioning health systems, and can help make drugs more widely available in poorer countries, as happened in 2002 when HIV drugs were included.
In 2023, the experts decided against adding obesity drugs to the list, with WHO saying more evidence was needed on their long-term clinical benefit.
However, in the new memo recommending their use as a treatment, the agency says it supports including them on the list this time round.
It also raises concerns over the cost of the treatments and calls for longer-term studies on cost-effectiveness “across all settings, including LMICs” (low- and middle-income countries).
It points out that the same mechanisms used in large-scale medicine access programmes may need to be adopted, to improve access, like tiered pricing or pooled procurement.
But it also notes that the active ingredient in semaglutide – used in Wegovy – comes off patent in some markets next year.
Several companies are planning to launch cheaper generic versions of the drugs then. Liraglutide, the active ingredient in the older generation of drugs, is already available as a lower-cost generic drug, with products approved in the US and Europe, the memo adds.
See more from MedicalBrief archives:
WHO warning about weight-loss drugs as obesity guidelines amended
New US guidelines recommend weight loss drugs for obesity
Lilly sues compounders over copies of weight-loss drugs
Why I think weight loss drugs are not the answer – US obesity expert