
Exclusive: WHO set to back use of weight-loss drugs for adults globally, raises cost issue
LONDON, May 1 (Reuters) - The World Health Organization plans to officially back the use of weight-loss drugs to treat obesity in adults for the first time, a memo reviewed by Reuters on Thursday shows, marking a shift in its approach to treating the global health problem.
The UN agency also called for strategies to improve access to the treatment in low- and middle-income countries.
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More than a billion people now have obesity worldwide, according to the WHO, and around 70% of them live in low and middle-income countries, the World Bank estimates.
The wildly popular obesity drugs - Wegovy developed by Novo Nordisk (NOVOb.CO), opens new tab and Zepbound by Eli Lilly (LLY.N), opens new tab - are known as GLP-1 receptor agonists, which mimic the activity of a hormone that slows digestion and helps people feel full for longer. In clinical trials, people lost 15% to 20% of their body weight, depending on the drug.
The drugs have been launched in the United States and other high-income countries like Germany and Britain.
But they can cost over $1,000 a month, and studies suggest people may have to take the drugs for the rest of their lives to keep the weight off.
The WHO, Eli Lilly and Novo Nordisk were not immediately available for comment.
The WHO's conditional recommendation will be officially released in August, as part of new guidelines on treating obesity. It is also working on separate guidelines for children and adolescents.
Separately, WHO experts will also meet next week to decide whether to include the GLP-1 drugs in the agency's essential medicines list - both to treat obesity and type 2 diabetes.
The WHO's essential medicines list is a catalogue of the drugs that should be available in all functioning health systems, and it can help make drugs more widely available in poorer countries, as experts say happened in 2002 when HIV drugs were included.
In 2023, the experts decided against adding obesity drugs to the list, with WHO saying more evidence was needed on their long-term clinical benefit.
However, in the new memo recommending their use as a treatment, the agency says it supports including them on the list this time round.
Still, the WHO also raises concerns over the cost of the drugs and calls for longer-term studies on cost-effectiveness "across all settings, including LMICs" (low- and middle-income countries).
"The same mechanisms that are used in large-scale medicine access programmes may need to be adopted," to improve access, the WHO adds, such as tiered pricing or pooled procurement.
But it also notes that the active ingredient in one of the newer drugs, semaglutide - used in Novo's Wegovy - comes off patent in some markets next year.
Several companies are planning to launch cheaper generic versions of the drugs then. Liraglutide, the active ingredient in the older generation of drugs, is already available as a lower-cost generic drug, with products approved in the U.S. and Europe, the memo adds.

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Daily Mail
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Three members—speaking anonymously to The Times—described the onset of debilitating anxiety, sleeplessness and panic attacks after starting Mounjaro. One said the anxiety felt like a kind of 'terror' she had never experienced before. The cases have prompted fresh questions over the safety profile of the medications as their use becomes more widespread. Charlotte Lloyd, 37, a social media manager from London and member of the online group, had anxiety symptoms so bad she found herself in A&E, The Times reported. Last autumn she gained weight during her fertility treatment, so she had a BMI high enough to qualify for the prescription weight-loss jab Mounjaro. While NHS access to the weight loss jab remain limited, the Mounjaro jab is widely available through online doctors and private clinics. To be eligible you must have a BMI of 30 or more, or a BMI between 27 and 30 (overweight) and a weight-related health condition such as prediabetes. 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I've never had a panic attack or anxiety. I've always been a laid-back person and now it's like everything is stressful. 'I get this thing that we've termed 'air hunger' where it's like I can't take a deep breath. If I'd have known Mounjaro could have mental health side-effects I never would have taken it.' The third woman, Julie Peters, a 31 year-old mother from Birmingham had a similar experience after getting the jab. She had a panic attack that lasted two hours on January 11, after taking the lowest dose, 2.5mg, of Mounjaro, once a week for two months. The mother went to A&E also thinking she was having a heart attack, but similarly she said: 'tests on my heart, kidneys, and for pancreatitis all came back clear. Ms Peters also described experiencing tremors, a 'tugging' sensation in her brain' and tinnitus—'The ringing in my ears has been constant, sometimes with multiple ringing sounds. 'The pressure and heaviness in my brain make me feel dull, disconnected and nauseous, and I also have a sensitivity to motion. 'I recently requested a brain MRI, and while the results came back normal, I am relieved yet uncertain about what to do next. It's incredibly suffocating,' she said. It follows a study published in January last year in the International Journal of Clinical Pharmacy which found 481 psychiatric events were linked to weight loss jabs. The 'seriousness of the adverse events warrants additional research' to explore the causual relationship,' said lead authors, Hajer Elkout and Mansour Tobaiqy. This was despite psychiatric events only accounting for 1.2 per cent of total reports associated with the active ingredients in weight loss medications. Anxiety, depression nor insomnia were listed as potential side effects by Asda Online Doctor by Zava or in the patient leaflet they refer patients to. The clinical governance team at the private pharmacist who stressed patient safety told The Times all applicants are required to give their medical history. This includes their GP details which they said enables the GP to inform them 'of any discrepancies or concerns they have with the prescription'. They added there are studies evidencing mental health can be improved with treatment, and no clinical-based-evidence of a negative impact 'they are aware of'. Last year a study published in the journal of Natural Medicine found taking semaglutide for weight loss or diabetes reduced the incidence of suicidal ideation. However, a more recent study found Ozempic and Mounjaro can raise the risk of depression and suicidal thoughts. However, Asda Online Doctor by Zava added: 'Our doctors, of course, will provide suitable advice to any particular patients of concern or who are managing complex mental health issues and may not be able to use the treatment appropriately alone. 'These patients, where necessary, will be signposted to their GPs for further support to manage their weight.' The manufacturers of Mounjaro, Eli Lilly, and of both Ozempic and Wegovy, Novo Nordisk told The Times patient safety was their top priority. 'We take any reports about patient safety seriously and actively monitor, evaluate and report safety information for all our medicines,' said Eli Lilly. With Novo Nordisk adding it welcomes: 'Independent research investigating the safety, efficacy and clinical utility of our products.' The two drug companies both highlighted that the UK regulatory agency had assessed the risk and benefits approving their respective drugs. Novo Nordisk added that independent analysis 'did not find an association between use of GLP-1RA medicines and the occurrence of increased risk of suicidal thoughts or actions.'


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