Roll out of weight loss drugs in England could be dramatically sped up to millions of working age adults by making use of existing private providers and a ‘digital first’ approach, a report from the Tony Blair Institute has concluded.
The analysis said faster roll out through more innovative models of providing anti-obesity medications such as semaglutide and tirzepatide would save billions a year in benefits payments through keeping people in work longer.
Such a scheme should be targeted at those over 40 years old and of working age, to ‘maximise the macroeconomic benefit’, the report said.
Modelling for the report suggests that giving 14.7 million adults the drugs over the next two years would save £52 billion by 2050.
Current plans to slowly phase access to the drugs outlined by NICE and NHS England will further widen health inequalities by perpetuating access based on ability to pay rather than need, the report from the think tank added.
Instead, eligibility for the drug should be broadened to all those with a body mass index of 27 or above and with free treatment given on a means-tested basis.
For those not eligible for free prescriptions, patients could either pay or share the cost with their employer through workplace-based schemes, the report concluded.
Patients should be able to access treatment through the NHS App with medications delivered to their door rather than having to access care in a clinic, it recommended.
It has been estimated that around 1.5 million people are already using weight-loss medications in the UK mainly through online providers.
Phased roll out plans from NHS England are due to start in June with GPs able to prescribe tirzepatide (Mounjaro) to the first priority cohort who have a BMI of 40 or higher and more than four other comorbidities such as hypertension or diabetes.
While capacity and cost were valid concerns, they are based on the assumption that patients would have a great deal of wraparound care including 21 GP visits in the first year, the TBI report said.
In addition, it does not take into account reduced costs from deals that could be made with pharmaceutical companies. With many more drugs in phase 3 trials, prices are also likely to fall through competition, it added.
‘As long as strict clinical governance standards were set, the NHS could expand access to [anti-obesity medicines] far faster than under current plans by commissioning private-sector providers to deliver weight-management services using established digital-first delivery mechanisms,’ it said.
It called for a separate government function – called Protect Britain – to deliver on prevention schemes such as access to ani-obesity medications.
‘Protect Britain should promote the uptake of prevention services, including weight management, through the expansion of the UK’s Health Check programme’, it continued although patients should be able to self-refer to weight-management services at any age if they are eligible.
And the government should expand the remit of NICE to consider the macroeconomic benefit of large-scale, high-impact innovations, it said.
So that GPs would have access to patient information on anti-obesity drugs delivered on behalf of the NHS through private providers, a ‘robust data-exchange platform’ should be put in place to ‘exchange, link and process clinical and administrative data’.
It would also automatically link patient-level clinical data across public and private services to ensure ‘providers across both sectors could access the medical history of their patients, and that NHS clinicians could have sight of any GLP-1 medications prescribed privately’, it said.
Health and social care secretary Wes Streeting said: ‘Obesity is a huge drag on the NHS, the economy, and the quality of people’s lives, and these medications are an exciting innovation.
‘We’re working with the NHS to trial new approaches and digital-first technologies to get these treatments to people faster, all while safeguarding capacity in our health service.’
Katharine Jenner, the director of the Obesity Health Alliance, said the clearly lays out the economic benefits that could come from greater investment in weight-loss drugs.
‘But medication alone won’t fix a system that drives poor health from the very earliest years of life. We cannot outsource our children’s future health to pharmaceutical companies.’
“We cannot outsource our children’s future health to pharmaceutical companies.”
But that is precisely what TB and his consultancy chums are doing. It’s not a report; it’s marketing.