Ireland is on the brink of a revolutionary change in the way it handles obesity treatment, but the high cost of drugs associated with it is causing disquiet amongst health officials. The country is set to introduce a number of innovative treatment methods that could help combat the rising tide of obesity that threatens to take root. However, with drug prices soaring, some health leaders are concerned that these new programs may not be financially viable in the long run. This article examines the dilemma of balancing new treatment options with cost concerns and how it may impact the future of obesity treatment in Ireland.
Ireland is on the brink of a revolution in obesity treatment, thanks to new weight-loss medications that have been deemed miracle drugs. Despite their efficacy, the high cost of these medicines is causing a headache for the health service, sparking concerns about affordability and equity of access. The new treatments are generating an unprecedented demand worldwide, leading to massive product shortages. While Ireland is behind other countries in making these treatments available, the Health Service Executive (HSE) started reimbursing the first new-generation drug for the treatment of obesity, Saxenda, in January 2021. With a 42% increase in demand, the HSE now expects to spend more on anti-obesity treatments in just one year than it had budgeted in five.
This demand is likely to rise even more with the advent of the highly effective new drug Wegovy. With fewer side effects, such as once-weekly injections compared to daily ones for Saxenda, the demand for Wegovy is expected to be high. Furthermore, other products under development that are yet more effective for weight loss are on the horizon. These new treatments offer hope to people who have been struggling with excess weight for many years, and for whom other options have failed. According to Susie Birney, director of the Irish Coalition for People Living with Obesity, people who take these medicines can lose up to 20% to 25% of their excess weight, thereby vastly improving their quality of life.
Nevertheless, there are some drawbacks to these new treatments. Besides their high cost, there are side effects to consider, such as nausea and vomiting. In addition, people who stop taking these drugs risk regaining the weight they have lost. While the new drugs have transformed the clinical approach to treating obesity, they have become available at a time when access to the only other really safe and effective option for obesity treatment, bariatric surgery, remains very limited, especially for public patients in Ireland.
Prof Michael Barry, clinical director of the National Centre for Pharmacoeconomics, is responsible for assessing the cost-effectiveness of new medications. He acknowledges that these new drugs are different because they are very effective and reasonably well-tolerated by patients. However, there are concerns about their long-term effects, as they are expensive and need to be taken for life. Barry’s main concern is cost, as Ireland already spends €55 million a year on anti-obesity drugs, and this cost is expected to soar with the arrival of Wegovy.
To mitigate this cost, a managed access programme that limits drug access is likely to be implemented soon. Patients who have a body mass index of 35 or more, are pre-diabetic and have evidence of cardiovascular disease such as high cholesterol or high blood pressure will qualify for Saxenda. Half of the 2,600 applications for the drug since January have been rejected on these grounds. A similar programme is expected to be used for other obesity drugs.
Birney believes that while she understands the government’s concerns about cost control, these treatments have given people who have tried everything else without success a new lease on life. Many people lose weight multiple times but cannot maintain the weight loss because obesity is highly genetic, with 40% to 70% of obesity being heritable. Birney has lost significant weight five times in her life, but every time, the weight returned and increased. As a result, she believes that these drugs offer hope to people who have been suffering from excess weight for decades, and whose bodies are resistant to other interventions.
The development of these new treatments is a significant breakthrough in the treatment of obesity and its complications. With their potential to help individuals lose weight, some are concerned about the cost and access to such treatments. However, it cannot be overlooked that these treatments have given people a sense of hope and the possibility of an improved quality of life.
In conclusion, Ireland is on the verge of an obesity treatment revolution, with new drugs and therapies promising to help millions of people fight this growing epidemic. However, the high cost of these drugs is causing disquiet among healthcare providers and patients alike. It’s essential that we strike a balance between affordability and access to these treatments, ensuring that everyone who needs them can get them without having to worry about the financial implications. With a concerted effort from all stakeholders, we can make sure that Ireland leads the way in tackling obesity and improving the health of our citizens.
