Demand for weight loss drug more than 45 times higher than expected

New obesity medicines have potential to use up entire State drugs budget, conference hears

Demand for the only weight loss drug funded by the public health service is running at more than 45 times higher than was expected, a conference on the cost-effectiveness of medicines has heard.

When the HSE started funding Saxenda last January, between 100 and 150 applications were expected.

However, some 6,700 applications have been received to date, according to Prof Michael Barry, director of the National Centre for Pharmacoeconomics (NCPE), the State agency that assesses the cost-effectiveness of new medicines.

Around half of these applications have been approved based on eligibility criteria. Three-quarters of the applications were from women, and the average age was 50.


Globally, there has been a huge surge in demand for new-generation weight loss drugs, including Saxenda, often driven by celebrity endorsement.

An even more effective drug, Wegovy, is not yet available in Ireland. A third drug, Ozempic, is reimbursed, but only for diabetes patients.

One patient Prof Barry saw last week lost 31kg by taking one of the drugs and was able to stop taking blood pressure medication, he noted. However, he added that the weight loss drugs have the potential to use up the entire budget for new drugs if everyone with obesity avails of them.

Evidence is now emerging that semaglutide, the active ingredient in Wegovy and Ozempic, can reduce serious cardiovascular events and benefit heart failure patients, Prof Barry told the conference.

“They will go from weight loss to cardiovascular medicines; are we ready for that?”

The State’s total bill for medicines has risen every year over the past decade and now stands at between €3.2 and €3.3 billion, he said. This increase has been driven in particular by new high-tech drugs – 1 per cent of prescriptions account for 40 per cent of spending. The seven cancer drugs the NCPE has assessed this year have a combined cost of €117 million.

The lack of any dedicated funding for new drugs in last week’s budget would lead to delays in patients accessing treatments, he warned, but savings can be made and reinvested.

“We can make efficiencies in this and we should. We need to redouble our efforts.”

Calling for a greater focus on the outcomes for patients taking new treatments, he said that “often” they do not result in an improvement in quality of life.

Prof Barry said the question has to be asked as to whether Ireland could be, and should be, spending the money elsewhere.

While the NCPE’s assessments are necessary, they are not sufficient to ensure the optimum use of scarce health resources, he said. Just because a drug was cost effective did not mean it would be used in a cost effective way. For this reason, more is being done to manage the cost of medicines after approval.

Many areas of healthcare and Sláintecare will stand still as a result of the Government’s decision not to fund new medicines in the budget, according to Irish Pharmaceutical Healthcare Association president Michael O’Connell. However, he said in a modern, health-focused society “standing still is going backwards”.

The Government and its finance officials seem to want all the “proceeds” of a strong pharmaceutical industry in Ireland – “the manufacturing, medical innovation, the ribbon-cutting and opening of manufacturing plants, investment in jobs” – without providing the benefit of investment in new drugs, he said. “This makes life harder for all of us.”

The pharma industry wants to be “part of the solution” by being represented at the negotiating table, he said.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.