Weight loss jabs could be transformative, says outgoing NHS England official
Cholesterol-busting statins are one of the most commonly prescribed drugs in the UK, with around seven to eight million people taking them to cut their chance of heart attack and stroke.
An estimated 1.5 million are taking weight loss jabs in the UK.
Professor Sir Stephen Powis, the outgoing medical director of NHS England, said the NHS needs to go 'further and faster' to 'turn the tide' on rising levels of obesity.
Later this month GPs in England will be allowed to prescribe mounjaro, also known as tirzepatide, for the first time.
Patients previously needed to access the drugs through a special weight loss service.
Speaking at the NHS ConfedExpo conference in Manchester, Sir Stephen hailed the rollout in GP surgeries as an 'exciting milestone' and said NHS officials are also examining ways to 'broaden access to the drugs'.
Around 29% of adults in the UK are obese.
Sir Stephen said: 'Right now, obesity is estimated to cost the NHS approximately £11.4 billion every year – this financial burden is unsustainable for the NHS and wider economy.
'We have to turn the tide. We have to and will go further, and faster.
'In just a few years from now, some of today's weight loss drugs will be available at much lower cost. This could completely transform access to these innovative treatments.
'But we will and must be guided by the evidence base and must do this safely and sustainably, in a way that ensures that we are equipped as a health service to deal with the demand.'
He said he is not 'starry-eyed' about weight loss drugs, adding they are 'no silver bullet'.
He told reporters: 'These medicines can be harmful if they are prescribed without the right checks and wraparound care – they can have side effects, including nausea, dehydration and inflammation of the pancreas, and a worrying number of people are continuing to access them without appropriate checks via the internet.
'We are ambitious and determined to explore different methods of delivery and strengthen the evidence base and will do so alongside this phased rollout, but this is a historic first step in widening access, with 220,000 people set to benefit from the rollout over the first three years.
'So I think over time it's highly likely that they will become more widespread, the evidence base will increase, we will learn better how to deploy them, we'll learn how long people need to be on them, and in terms of weight reduction, how much weight reduction is maintained once people come off – that's a big unknown.
'We see this every time we have a new class of drugs in the early days. But there's still much more to learn.
'There will be more drugs coming on the market; there will be different prices for drugs, we will get to generics, which means that prices will fall.
'We have been through this with statins, and the use of statins is now very different from when they first came out, and I've no doubt that will be the same for these drugs.
'So it's very exciting, but we're in the foothills of learning how to use them.'
Asked about statins, Sir Stephen said: 'So firstly, obesity is associated with a whole set of conditions (such as) kidney disease, cardiovascular disease, respiratory conditions.
'So in reducing weight, you will, by the very nature of doing that, be reducing the risk of a whole set of difficult conditions and aiding with their management where people already have them.
'Whether the drugs have effects beyond that, I think, is a research question, and there will be an evidence base being generated.
'And it's not completely unusual for drugs over time to be found to have effects that go over and beyond what they were initially designed for.
'So I think we will wait and see. But obviously, the first task, amongst all the excitement and all the discussion and debate, is to actually get on and deploy tirzepatide in particular.
'We have been focused on getting this rolled out by the end of this month… and that is going to be a really exciting milestone.
'It's going to be a very exciting journey, and there will be things on the way that we haven't expected.'
He added: 'We set out the our plan for uptake – Nice (National Institute for Health and Care Excellence) have asked for a review of that after three years, which is quite right, because it's quite a long horizon.
'Cost is one element of that, but I think we will learn more about the outcomes that these drugs are driving in terms of lower cardiovascular events and reducing the conditions that we know associated with obesity.
'So absolutely, cost is one element of that, but it's not the only element. We want to look carefully at what the science tells us.'
Sir Stephen added: 'When I look back when dialysis came in, we didn't use dialysis for older people. Over years the technology improved, we got more confident, more people were able to access the treatment.
'So we've much to learn with these drugs. It's a really exciting time.'
He went on: 'We want to broaden the ways in which you can access these drugs – so we're very interested in thinking about pharmacies, thinking about digital.
'We will deliver the structured support through a combination of digital and face-to-face.
'But we want to innovate. This can be a model that is not just about GP prescribing, but we need to learn how to do that.'
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