The slimming drug semaglutide, marketed as Wegovy, will not be included in the basic health insurance package for the time being. The Netherlands Healthcare Institute has advised Minister Fleur Agema (PVV) of Public Health against reimbursing the drug due to concerns about its impact on the healthcare budget, among other reasons, deeming such reimbursement “socially irresponsible.” Typically, the Minister of Health follows such recommendations.
According to the Healthcare Institute, Wegovy has demonstrated effectiveness in reducing body weight and offers additional benefits to patients without type 2 diabetes compared to the already reimbursed drug liraglutide (sold as Saxenda). However, global demand for Wegovy has led to shortages, and the expected costs are likely to exceed €10 million. Novo Nordisk, the manufacturer, is required to submit an economic evaluation for amounts exceeding this threshold, but the Healthcare Institute has expressed significant doubts about the adequacy of the economic analysis provided.
The manufacturer’s disease and treatment model, used to project long-term treatment consequences, is described as overly complex and non-transparent, making it unsuitable for informed decision-making. Additionally, the Healthcare Institute does not have the authority to advise on price negotiations between the Minister and the manufacturer.
The advice notes that potentially 4.2 million people in the Netherlands could be eligible for Wegovy, highlighting uncertainties regarding appropriate patient selection and the drug’s long-term cost-effectiveness if patient numbers increase. Previous underestimations of user numbers for other weight-loss drugs suggest annual healthcare costs could escalate to €1.3 billion if patient numbers rise significantly.
This assessment marks the first time the Healthcare Institute has evaluated the cost-effectiveness of a weight-loss drug; previously, obesity treatments were exempt from economic evaluations if costs remained below the €10 million threshold. The Healthcare Institute acknowledges that this decision may disappoint patients and healthcare providers, as stated in the letter received by Minister Agema.
