The HSE’s slowness to approve weight loss medication for inclusion in the Drug Payments Scheme seems at odds with Ireland having one of the highest obesity levels in Europe.
About 60 per cent of adults and more than one in five children and young people are classified as either overweight or obese, according to the HSE which has, to date, only included one weight loss drug – Saxenda – in the scheme which caps a family’s monthly drug bill at €80. It is only available to patients with a body mass index (BMI) above 35 who are also pre-diabetic and at risk of cardiovascular disease. According to the HSE, a healthy BMI is in the region of 18 and 25.
Another weight loss drug, Mounjaro, is being assessed for inclusion in the scheme and two others – Ozempic and Wegovy – are not currently included. Private health insurers VHI and Laya have said they will not be covering Mounjaro because it is not administered in a hospital setting.
The HSE’s obesity policy and action plan for 2016 to 2025 recognises that obesity and overweight are among the most significant public health challenges. The plan was drawn up before the current group of weight loss drugs became available and its emphasis is primarily on prevention, particularly among children. Its expiry this year provides an opportunity to consider the issue.
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Arguably the biggest non-clinical factor militating against subsidising the widespread use of the drugs is their cost, which can run to ¤2,500 a year per patient. The financial implications of including them in the Drug Payments Scheme and lowering the relevant BMI threshold are significant.
The economic cost of obesity is significant and could be up €1. 5 billion a year, according to HSE figures. Other estimates are even higher. Approximately a third of the total related to direct healthcare costs and the remainder to indirect effects such as reduced or lost productivity and absenteeism. A decision on whether to include the drugs in the Drugs Payment Scheme has to be made in this context.
