German health insurance may cover Wegovy for strokes, heart disease, agency tells ET HealthWorld
German health insurance may cover Wegovy for strokes, heart disease, agency tells ET HealthWorld

By Ludwig Burger

Frankfurt: Germany’s public health insurance scheme may cover certain patients at risk of heart disease or strokes to take the weight-loss drug Wegovy, a major boost to Novo Nordisk’s efforts to convince governments of its wider medical benefits.

The European Union’s medicines regulator is reviewing the wider use of the hugely popular weight loss drug Wegovy to include reducing the risk of strokes and heart attacks, adding to its previously approved use to tackle obesity.

The guidance, published online late Thursday by the G-BA health agency for Europe’s largest national drug market, said the regulation barring Germany’s health insurance system from paying for slimming drugs such as Wegovy would not apply in of other approved uses of a weekly injection.

Novo Nordisk is pushing to expand insurance coverage in Europe by showing health benefits beyond weight loss.

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In a similar ruling Thursday, the US agency that oversees the Medicare program for the elderly said heart patients under its purview would be covered by Wegovy as long as it was prescribed to reduce their risk of heart attacks and strokes.

US Medicare prescription drug plans administered by private insurers also currently cannot cover obesity drugs.

The EU review is based on a study known as Select, which showed the drug could reduce the risk of heart attacks, strokes or death from heart disease by 20 percent in certain overweight people who already had serious cardiovascular problems.

The G-BA officially confirmed that Germany’s statutory health plans do not have to pay for Wegovy when prescribed for weight loss, but added a caveat.

“In the event that the requested extension of approval is granted, it should be noted for clarity that the use of Wegovy to reduce the risk of cardiovascular events after pre-existing cardiovascular disease … is not subject to the regulation,” the committee said in his guidance.

The G-BA and Medicare guidance is likely to have implications beyond Wegovy’s use, as Novo’s rival Eli Lilly is also conducting trials to show additional health benefits of the highly effective weight-loss drug Mounjaro, also known as tirzepatide.

The G-BA is a committee made up of representatives of doctors, medical insurers and hospitals, which plays a key role set by the government in setting treatment standards and financial coverage.

The German policy, declaring weight-loss drugs to be lifestyle products that people must pay for themselves, affects mandatory state-controlled health plans that cover 90 percent of people in Germany.

Many other European countries have maintained a restrictive stance when it comes to health system coverage.

Rising demand for Wegovy and the diabetes drug Ozempic, which is based on the same active ingredient, has doubled Novo’s share price in the past two years, but has also overwhelmed the company’s ability to ramp up production of the weekly injections.

For now, people paying for weight-loss drugs out of pocket is a major driver of sales growth for Novo and Lilly, but public sector insurers could support longer-term momentum, analysts said.

(Reporting by Ludwig Berger; Editing by Mathias Williams and Elaine Hardcastle)

  • Posted on March 22, 2024 at 6:17 PM IST

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