Pharmac Urged to Fund Weight Loss Drug for Teens: A Controversial Decision or a Lifesaving Measure?
A leading paediatric specialist is making a compelling case to New Zealand's drug funding agency, Pharmac, urging them to consider funding a weight loss medication for teenagers. The drug in question, Wegovy, has been provisionally recommended by a Pharmac advisory panel for chronic weight management in individuals with high BMIs and associated conditions.
The semaglutide medication, available since July last year, carries a monthly cost of approximately $460. The advisory group's recommendation is contingent upon meeting Special Authority criteria, which will restrict who can prescribe it. This decision was made after the advisory group's December meeting, with a comprehensive record expected to be available by March.
However, Professor Wayne Cutfield, a renowned expert in paediatric endocrinology, believes that many teenagers stand to benefit from this drug if it receives funding. He highlights the alarming rate at which severely obese teenagers gain weight, often reaching between 120 and 150 kilograms at ages 14 to 16. Cutfield warns that without intervention, these teenagers are at risk of developing severe obesity by the time they reach 45 years old.
The professor argues that funding Wegovy for teens is a proactive approach to preventing serious health issues. He questions the wisdom of Pharmac's potential decision to deny funding, suggesting it would be akin to 'closing the gate after the horse had bolted.' Cutfield emphasizes the potential health risks, including heart attacks, strokes, diabetes, and liver disease, which could be mitigated by early intervention.
Real-world follow-ups of patients who have taken Wegovy reveal that weight regain can occur rapidly after discontinuing the medication due to its appetite-suppressing effects. Cutfield underscores the importance of lifestyle changes in sustaining weight loss and reducing the lifelong reliance on the drug.
Despite the potential benefits, there are concerns about accessibility. At a monthly cost of $460, Cutfield acknowledges an 'equity issue' in accessing Wegovy. He emphasizes the potential cost-effectiveness of funding the drug, citing the prevention of severe diseases with substantial treatment, hospitalization, and lost work costs.
Pharmac's director, Dr. David Hughes, clarifies that age is not typically a primary factor in funding decisions, unless there's a strong clinical rationale. The agency has received two applications for funding Wegovy, one for individuals with established cardiovascular disease and a BMI of 27 or higher, and another for chronic weight management in those with a BMI of 30 or higher and at least one weight-related comorbidity.
New Zealand's adult obesity rate is alarmingly high, ranking third in the OECD. The debate surrounding funding decisions for such medications is complex, and it invites discussion on the balance between accessibility, cost, and long-term health outcomes.
