The Wegovy GLP-1 weight-loss pill has been approved in the UK, making it the first oral GLP-1 to be given the go-ahead in Europe.
“Having met the MHRA’s rigorous standards of safety, quality and effectiveness, the semaglutide tablet has been approved in the UK for weight loss and weight management,” says Julian Beach, executive director of healthcare quality and access at the Medicines and Healthcare Regulatory Authority.
It’s a once-daily pill and will now become available for private prescription, but it still under review by the National Institute for Health and Care Excellence (NICE) for use in the NHS.
It is likely to mean a sharp uptake in users. New data shows that three million prescriptions of the Wegovy pill have been dispensed in the US since its January launch and a large number of those were for people new to GLP-1s.
“The approval of an oral semaglutide tablet is a significant moment for weight management in the UK because injections are still a very real barrier for some patients,” says Dr Nadia Ahmad, medical director of The Weight Care Clinic. “Some people are needle anxious, some dislike the ‘medical’ feeling of injecting and others simply prefer the discretion of taking a tablet.”
Who can use it?
It can be prescribed to adults with obesity who have a body mass index (BMI) of 30 or above, or who are overweight with a BMI between 27 and 30 and at least one weight-related comorbidity, and should be used alongside a reduced-calorie diet and increased physical activity.
“My biggest caution is that this could widen access, but it could also widen misuse if people treat it like a casual weight loss tablet,” says Dr Ahmad. “GLP-1s are prescription medicines, not cosmetic products.”
Dr Kieran Seyan, chief medical officer at Pharmacy2U offers caution on unregulated use. “The availability of an oral option does not change the need for lifestyle support, dietary measures, monitoring and ongoing clinical follow-up,” he says. “As public interest in medicated weight management grows, it is increasingly important that patients use reputable clinical services rather than unregulated online sources or counterfeit products.”
Can current injectable users swap over?
Those currently treated privately with a 2.4mg semaglutide injection once weekly can be transitioned straight to semaglutide 25mg tablets once daily, according to the MHRA.
The pill may also be cheaper, but this is yet to be confirmed. “I think it is unlikely we will see such a significant price difference between the pen and the oral tablet as we have seen in other countries, given the pen is very competitively priced in the UK, compared to say the USA for example,” says Dr Luke Pratsides, chief medical officer at Get A Drip. “However, because providers will not need to maintain the cold chain delivery required for the injection pen with the oral tablet, there is a lower cost to the provider, which should then be reflected in a lower price to the patient.”
For new users, the starting dose for the semaglutide tablet is 1.5mg once daily, increasing to 4mg, 9mg and 25mg with a minimum duration of one month at each dose level.
How soon can UK consumers get the Wegovy pill?
“For private prescription, while there might be no requirement to await NICE approval, the actual stock of the treatment will need to be manufactured, imported and distributed through the UK supply chain before pharmacies can dispense it,” says Ana Caroline Gonvalves, superintendent pharmacist at Pharmica. “However, patients and prescribers can expect actual dispensing and availability to providers in the coming weeks.”
The future of oral GLP-1s in Europe
In May, the European Medicines Agency committee responsible for human medicines recommended an extension to the marketing authorisation for Wegovy to include its Wegovy pill. It has put its opinion forward to the European Commission for authorisation.
Eli Lilly’s orforglipron (Foundayo) was the oral GLP-1 used in recent research showing that it can help to maintain weight loss after using an injectable. It is also under UK and EU review and may soon be approved.
If they get the go-ahead, food and beverage is likely to see an increase in appetite-suppressed consumers and it needs to be ready.
