Novo Nordisk's obesity drug, Wegovy, will be launched in Germany this month, marking its third European market. However, only individuals who pay out of pocket or have specific private
health insurance plans will have access to the medication.
A long-standing German law prohibits public health insurance schemes from covering weight-loss drugs, classifying them as lifestyle choices rather than medical necessities, similar to impotency or baldness pills. Consequently, the cost of Wegovy, which has a monthly price of $1,350 in the United States, will not be reimbursed for the 90% of Germans covered by these plans. Novo Nordisk has yet to set a price for Wegovy in Germany, the largest pharmaceutical market in Europe.
Germany's strict stance on weight-loss drugs is among the toughest in the region, despite the country's overweight population surpassing the European Union average. This highlights the challenge faced by Novo Nordisk and its competitors in persuading European governments to cover the costs of obesity drugs, which is expected to slow their adoption in the region.
While some doctors argue that Wegovy could help address weight-related conditions and reduce healthcare costs, others prioritize promoting healthier lifestyles through diet and exercise over prescription drugs.
Production issues and difficulty meeting overwhelming demand in the United States have already resulted in a slower-than-expected rollout of Wegovy in Europe.
Germany's health ministry stated that there are no plans to revise the law to include weight-loss drugs in coverage. Concerns over costs straining an already stretched healthcare budget were mentioned by a Berlin lawmaker, who also indicated that expert panels overseeing reimbursement would evaluate the drugs' benefits beyond weight loss.
Advocacy groups emphasize the potential benefits of weight-loss drugs in terms of prolonging lives and keeping individuals in the workforce, highlighting the importance of a broader perspective.
Germany is not the only country imposing limitations. Public health insurance schemes in Norway and Denmark, the other European countries where Wegovy is available, do not cover the drug, considering the monthly costs of $160 to $350 too high relative to the benefits. Denmark's largest private health insurer will also stop covering the drug due to high demand next year.
In France, payment schemes only cover Wegovy for the treatment of severely obese individuals with a body mass index (BMI) of 35 or higher, surpassing the minimum set by European regulators when approving the drug in January 2022.
In the UK, initial access will be limited to hospital specialists and individuals with a BMI of 35 or higher. Family doctors will only be authorized to prescribe the drug following a two-year pilot scheme.
In contrast, in the United States, the federal Medicare health plan does not cover weight-loss drugs. However, many employer-funded health plans cover Wegovy, often requiring patients to attempt a strict diet program or try cheaper drugs first.
Barclays analysts predict that the global market for obesity drugs will exceed $60 billion by 2030, up from $2.9 billion in 2022. The United States is expected to account for about 60% of the market, while the European Union is projected to make up around 26%. Currently, approximately 53% of people in the EU are overweight or obese, compared to roughly 74% in the United States, although weight-related issues are rapidly increasing in most EU member states, according to Eurostat.
For Europe's predominantly universal healthcare systems, the concern lies more in the potential rise in costs than in weight-related problems over time. Photo by News Øresund - Johan Wessman, Wikimedia commons.