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British pharmacies and slimming clinics are reducing prices for weight-loss drugs Wegovy and Mounjaro in a competitive bid to win patients. Both Novo Nordisk's Wegovy (semaglutide) and Eli Lilly's Mounjaro (Tirzepatide) injection drugs are cleared for weight loss in combination with a reduced-calorie diet and increased physical activity. Wegovy was launched in the UK market in September, with Mounjaro following in February. Initially designed for treating type 2 diabetes, the drugs have been found to also induce weight loss by suppressing appetite and decelerating digestion. As reported by Reuters, Simple Online Pharmacy has further reduced the price of starter doses of Mounjaro to £149 for a one-month supply. In February, the price was cut to £159 ($198) from £179. Additionally, the pharmacy on Monday discounted the higher Mounjaro strengths that patients take later.

A comprehensive cohort study has shed light on the benefits and risks associated with weight-loss drugs, offering valuable insights for clinical care and future research. Published in Nature Medicine on 20 January 2024, the study found the use of glucagon-like peptide 1 receptor agonists (GLP-1RAs)-used to treat diabetes and obesity-associated with a reduced risk of substance use disorders (including alcohol, cannabis, opioid and stimulant use disorders). Weight-loss drug use was also linked to decreased risks of psychotic disorders, seizures, neurocognitive disorders (including Alzheimer's disease and dementia), coagulation disorders, cardiometabolic disorders, infectious illnesses and several respiratory conditions. However, the use of GLP-1RAs was not without risks, as researchers identified an increased risk of gastrointestinal disorders, hypotension, syncope, arthritic conditions, nephrolithiasis, interstitial nephritis, and drug-induced pancreatitis associated with their use. The analysis, utilising the U.S. Department of Veterans Affairs databases, compared 215,970 GLP-1 RA users with patients using sulphonylureas (n=159,465), DPP4 inhibitors (n=117,989), SGLT2 inhibitors (n=258,614), or a composite of the three (n=536,068).

U.S. Customs and Border Protection (CBP) officers at the port of Cincinnati seized two unapproved shipments of weight loss drugs, including one from a UK pharmacy, last month. On 5 October, CBP officers seized a shipment declared as "cosmetic weight loss product" and found containing Mounjaro injectable pens of multiple doses (2.5mg, 5mg, and 7mg). The shipment, arriving from a UK pharmacy and heading to a residence in Ohio, violated the Federal Food, Drug, and Cosmetic Act (FDCA), according to a U.S. Customs and Border Protection report. Cincinnati CBP officers on 14 October intercepted another shipment, which was also destined for an Ohio residence. This shipment from Hong Kong contained 20 vials of Semaglutide 10 mg and 150 Tirzepatide 30 mg, with a domestic value of $45,450. LaFonda D. Sutton-Burke, Director of Field Operations-Chicago, stated that seizures involving these types of unapproved medications are a common occurrence that her officers see on a regular basis.

A 58-year-old nurse from North Lanarkshire, Scotland, has reportedly died after taking the weight-loss drug tirzepatide, which was recently approved for use on the NHS. Susan McGowan died from multiple organ failure, septic shock and pancreatitis, with the use of the Eli Lilly drug listed as a contributing factor on her death certificate, according to the BBC. She had taken two low-dose injections of tirzepatide, known by the brand name Mounjaro, over a two-week period before her death on 4 September. Her death is thought to be the first in the U.K. officially linked to the drug. McGowan, who had worked for over 30 years as a nurse at University Hospital Monklands in Airdrie, purchased a prescription for the drug through a registered online pharmacy. A few days after her second injection, McGowen began experiencing severe stomach pains and sickness. She went to A&E at Monklands - where her colleagues tried to save her life. Within days, her kidneys failed, and she fell into a coma as her other organs began to fail.

The General Pharmaceutical Council (GPhC) has published updated guidance on online pharmacy services in Great Britain, introducing additional safeguards to prevent unsafe supply of high-risk medicines, including weight loss injections. Under the new rules, medicines used for weight-management and medicines requiring physical examination before a prescribing decision is made have been added to the list of high-risk medicines. When prescribing these medicines, prescribers can no longer rely solely on online questionnaires. Instead, they must independently verify patient information, either through timely two-way communication with the person, accessing the person's clinical records, or contacting the person's GP, their regular prescriber, or a third-party provider. These measures aim to prevent individuals from providing false information to obtain medicines that may not be clinically appropriate for them, reducing potential harm. The pharmacy regulator updated its guidance in response to concerns identified relating to unsafe prescribing and supply of medicines online.

A new class of weight loss drugs developed by Novo Nordisk and Eli Lilly "opens the possibility of an end to the obesity pandemic" alongside other interventions, the World Health Organisation (WHO) said this week. But the global health agency said it has concerns that unless health systems prepare properly, the drugs could distort the response to the global obesity crisis, risking leaving people behind and overshadowing other steps to improve health. The new drugs "have the potential to be transformative", according to the WHO's chief scientist, Jeremy Farrar, its director of nutrition, Francesco Branca, and his senior adviser, Francesca Celleti, in an opinion piece in the Journal of the American Medical Association (JAMA). The article is the agency's clearest comment yet on the potential of the new drugs, known as GLP-1 receptor agonists. But "medication in isolation will not be enough to address the obesity crisis," they added, calling instead for the innovation to push clinicians, governments, the pharmaceutical industry and the public towards considering the condition a chronic disease that needs further study into how best to prevent and treat it.

New data on weight loss drugs that could compete with Novo Nordisk's Wegovy are raising expectations there will soon be more options, and possibly lower prices, in an estimated $100 billion marketplace, doctors and pharmaceutical executives say. Drugmakers are ratcheting up their research and aiming for new formulations that can be taken as pills, options to deliver higher weight loss or drugs that reduce fat while maintaining muscle. "It has really been an explosion of innovation," said Dr. Robert Gabbay, chief science officer at the American Diabetes Association (ADA), which receives funding from both Novo and Eli Lilly and Co and just concluded its annual meeting in San Diego, California. "If there are multiple (treatments) in the market, that will lead to some level of competition and greater access."

Britain plans to launch a pilot programme exploring how new weekly weight-loss shots such as Novo Nordisk's Wegovy can be given to obese patients by general practitioners even as the drug's market launch remains unclear. The government's announcement on the £40 million pilot programme comes after drug cost-effectiveness watchdog NICE in March recommended the use of Wegovy in adults with at least one weight-related condition and a body mass index of 35, but only within the NHS specialist weight management scheme. The timing of Wegovy's launch in Britain - which would be only the fourth country to use it - is uncertain, however, after Novo last month rationed starter doses to secure supply to U.S. patients already on the regimen, after it was overwhelmed by demand there. British Prime Minister Rishi Sunak said on Wednesday (May 7) the pilot and fighting obesity-related diseases could reduce pressure on hospitals. It would also support "people to live healthier and longer lives, and helping to deliver on my priority to cut NHS waiting lists". The NHS endured a tough winter in England in particular, with waiting lists hitting record highs and staff striking for higher pay amid double-digit inflation.

Britons paying privately for obesity drugs are increasingly choosing Eli Lilly's Mounjaro over Novo Nordisk's Wegovy, online pharmacies say, in a sign the US drugmaker is gaining ground on its European rival. Mounjaro is appealing to people because of its greater efficacy, six online pharmacies and two patients told Reuters, showing Novo's first-mover advantage is being challenged in the UK even though some pharmacies sell starter doses for the weekly injection for up to 40 per cent more than Wegovy. "Mounjaro is now vastly outstripping Wegovy," said Chemist4U CEO James O'Loan, who said for the past three to four months, Mounjaro has won about 70 per cent of its sales. Chemist4U and another online seller, Simple Online Pharmacy, estimate that as many as 500,000 people in the UK currently take either Mounjaro or Wegovy via prescriptions from private online pharmacies. Mounjaro, unlike Wegovy, is not available through the National Health Service (NHS) though it likely will be next year. Wegovy is only available through the NHS at specialist obesity clinics and in limited circumstances. There is no public data on prescription numbers but the government said last year it had capacity to treat about 35,000 patients.

"Our main concerns are that the use of what they call an asynchronous supply, where the prescriber neither sees nor talks to the patient at the time they issue the prescription, does lay itself open to perhaps people getting hold of medication that they shouldn't," the Head of Policy, PDA said. The Pharmacists' Defence Association (PDA) engages in a critical conversation on BBC Radio 4's Woman's Hour, shedding light on the online prescribing of weight loss drugs and advocating for safer practices. The PDA's spokesperson, Head of Policy Alima Batchelor, emphasised the importance of adhering to professional guidelines to ensure patient safety and mitigate regulatory concerns. During the feature, the PDA highlighted the complexities and risks associated with online supply chains, stressing the necessity for direct clinical consultations and pharmacist involvement in medication management. ""There are guidelines and advice about verification within the DiCE guidance, but it doesn't go quite far enough for us. We are concerned when patients decline to allow the online prescriber to advise their GP of what they're taking," Batchelor highlighted.

Novo Nordisk, the Danish drug manufacturer, has launched Wegovy, a weight-loss drug, in the UK market. This semaglutide injection will be available through specialist NHS weight management services for those who meet the National Institute for Care and Excellence (NICE) criteria or privately through registered healthcare professionals. Novo Nordisk allocated a portion of the available supply of Wegovy for NHS services, while confirming the existing shortage of semaglutide and projecting continued constraints in the foreseeable future. The drug can be obtained through the NHS and is additionally accessible for private purchase at pharmacies in the UK. The pricing for a one-month supply varies, ranging from £73.25 to £175.80, depending on the dosage. "We are committed to expanding treatment options for individuals with obesity and share the Government's goal of improving access to obesity care in areas of high unmet medical need," the company said in a statement. "We are closely monitoring Wegovy demand and collaborating with regulators and providers to ensure access to and continuity of treatment for people living with obesity."

Professor Kamila Hawthorne, chair of the Royal College of GPs, has cautioned that while weight loss drugs hold significant potential to enhance many patients' lives, they are not without risks. She also expressed concern that expanding the roll out of tirzepatide at the scale proposed by the National Institute for Health and Care Excellence (NICE) would have "significant practical and resource implications for the NHS and primary care." The final draft guidance from NICE, published on 5 December, suggests that around 220,000 people living with obesity will be offered the weekly injection, along with a reduced-calorie diet and increased physical activity, over the next three years. Marketed under the brand name Mounjaro by Eli Lilly, tirzepatide is recommended for people with a body mass index (BMI) of more than 35 and at least one weight-related illness. Accepting the request from NHS England to roll out the medication over 12 years, the NICE guidance proposes to prioritise those with the highest clinical need.

Wegovy maker Novo Nordisk said on Tuesday (Aug 8) a large study had shown the highly effective obesity treatment also had a clear cardiovascular benefit, boosting the Danish company's hopes of moving beyond its image as a lifestyle drug. The increasingly popular Wegovy has transformed the weight-loss market since its U.S. launch in June 2021, capturing the attention of patients, investors and celebrities worldwide. Novo's news lifted shares in Europe's second-most valuable listed company after LVMH by more than 17 per cent to record highs. They have now surged almost 165 per cent over the past two years. The results of the late-stage trial may help persuade insurers in the U.S. and cost-conscious health authorities in Europe to cover the cost of Wegovy, which is $1,300 a month in the United States, for a wider range of patients. U.S. law classifies weight-loss treatments as lifestyle drugs and bars the Medicare health plan for older Americans from covering them and experts said the new data could lead the U.S. government to reassess that.

The MHRA on Wednesday granted a license for Eli Lilly's new Alzheimer's treatment, donanemab, for use in adults with mild cognitive impairment or mild dementia due to Alzheimer's disease. However, the drug will not be available on the NHS, as the National Institute for Health and Care Excellence (NICE) concluded that it "does not currently demonstrate value for the NHS." The health spending watchdog explained that the costs of providing donanemab, including regular infusions and intensive monitoring for serious side effects, outweigh the relatively small benefits it offers to patients, and so it "cannot currently be considered good value for the taxpayer." Helen Knight, director of medicines evaluation at NICE, said: "For NICE to be able to approve a medicine for use in the NHS it must provide additional benefits to patients, and it must also represent a good use of NHS resources and taxpayers' money. Donanemab (also called Kisunla) is a monoclonal antibody drug given by infusion (through a drip in the arm). It targets and reduces beta-amyloid proteins, whose abnormal buildup is associated with Alzheimer's disease.

Diabetes drugs that also promote weight loss such as Novo Nordisk's Ozempic, becoming a darling of celebrities and investors, are being studied to tackle some of the most difficult-to-treat brain disorders, including Alzheimer's disease. Diabetes regimens, from Ozempic to old mainstays like insulin and metformin, appear to address several different aspects of the metabolic system implicated in Alzheimer's disease, including a protein called amyloid and inflammation, researchers say. The hope is that improving glucose utilisation and tamping down inflammation in the entire body - including the brain - could slow progression of debilitating diseases like Alzheimer's and Parkinson's. Several scientists interviewed by Reuters news agency pointed to mounting research supporting testing diabetes drugs against neurodegenerative diseases. Results are years away and success uncertain. But interest has been buoyed by recent positive data on Alzheimer's drugs developed by Eisai with partner Biogen and by Eli Lilly demonstrating that removing sticky amyloid plaques accumulated in the brain can slow cognition decline caused by the fatal mind-wasting disease. Those successes followed decades of futility that had left many questioning the validity of the amyloid theory behind most experimental Alzheimer's drugs.

Germany's Boehringer Ingelheim said on Thursday (Aug 17) it would conduct three late-stage studies for its obesity drug candidate after it showed up to 19 per cent weight loss after 46 weeks in a mid-stage trial. The private company plans to start enrollments for the trial of the drug, survodutide, which it co-invented with Danish biotech company Zealand Pharma, before the end of the year. The trials will evaluate the drug's safety and efficacy, Boehringer said, and added that it would provide further details on the studies before initiation. Boehringer and Zealand are among global drugmakers racing to grab a share of the potential $100 billion market for obesity treatments within a decade. Survodutide works by mimicking a gut hormone called glucagon-like peptide-1 (GLP-1), which suppresses appetite, as well as imitating another gut hormone called glucagon that helps break down fat.

Eli Lilly's weight-loss medicine Mounjaro, also known as tirzepatide, will be available in the UK within weeks as a four-dose pre-filled injection pen. The Medicines and Healthcare products Regulatory Agency (MHRA) has approved the drug to treat adults with type 2 diabetes and for weight management in obese patients. Branded as Mounjaro KwikPen, the injection is to be used together with a reduced-calorie diet and increased physical activity, the regulator said. "The public health importance of safe and effective treatments to help manage diabetes and obesity, which can have a significant impact on people's health, is clear. "This approval enables access to the approved Mounjaro pen in a more convenient presentation of a month's treatment, of one dose per week," said Julian Beach, MHRA Interim Executive Director, Healthcare Quality and Access.

The Medicines and Healthcare products Regulatory Agency (MHRA) has approved a new indication of semaglutide (Wegovy), authorising its use to reduce the risk of serious heart problems and strokes in adults who are obese or overweight. Semaglutide, a GLP-1 receptor agonist, was previously approved for use in the treatment of obesity and weight management, to be used alongside diet, physical activity and behavioural support. The latest approval establishes it as the first weight loss drug to be prescribed to prevent cardiovascular events, such as cardiovascular death, non-fatal heart attack and non-fatal stroke, in people with established cardiovascular disease and a Body Mass Index (BMI) higher or equal to 27 kg/m2. Novo Nordisk, the manufacturer of Wegovy, received this authorisation on 23 July following compelling evidence from a recent post-approval clinical study involving over 17,600 participants. The study demonstrated that Wegovy, administered at a dose of 2.4 mg once weekly via subcutaneous injection for up to five years, significantly lowers the incidence of major adverse cardiovascular events (MACE) by 20 per cent compared to a placebo.