Ozempicola? Blair’s weight-loss future swerves around safety

Profit is not an ugly word. It’s beautiful. May the Lord smite me with it.

The UK could use a good smiting with profits. Pharmacy could.

I love profits, but not everyone is quite so keen. The Tony Blair Institute (TBI) for one.

The TBI is not for profit, and it’s non-partisan. It is wholly funded by private donors including Saudi Arabia, the US government, Amazon, Uber, Bill Gates and Oracle.

In late May it released a long report into weight-loss jabs – aka GLP-1s, or if you’re Donald Trump, ‘fat shots’.

TBI rebrands them as AOMs (anti-obesity medicines), and wants to accelerate any rollout, switch consultations online, and drop the BMI threshold from 35 to 27, scooping up millions more citizens.

It also wants to install a TBI team (funded by the Treasury) which would arrange procurement of multi-millions of doses of GLP-1 medicines and oversee the subsequent treatment of millions of patients.

Huge news, potentially, for online operators.

Like Charlie and the Semaglutide factory, five lucky existing online weight-loss jab providers will be chosen to lead the charge.

Varnish

The weight-loss jab drama didn’t even need a Blair cameo to liven it up.

This a wonder drug to beat all wonder drugs.

Viagra was a wonder drug. Pfizer has made around $25bn from Viagra since it launched in 1998.

Novo Nordisk made around $26bn from weight-loss jabs in 2024 alone.

Drug companies around the world are re-focusing on formulations and formats, dreaming of a Wegovy-infused diet soda – ‘First it stopped making you fat, now it makes you thin!’

Ozempicola?

Rainclouds

Their popularity among consumers has lifted these medicines out of the realm of the average patient-doctor-pharmacist loop.

That presents a risk to the stringent medical supply chain.

Regulators are valiantly fighting the tide.

So, with no concern for profit, a strategy that put patient health first would pause online dispensing for weight-loss jabs, because it’s evidently vulnerable to exploitation by misguided or vulnerable people.

It would adopt an approach to obesity that would harness the potency, efficacy and rapidity of GLP-1s in a progressive and productive way, but not get carried away, because however exciting the potential is, GLP-1s remain in field-testing discovery mode.

It would call for physical examinations for all patients bracing themselves for such a robust physical experience.

And recommend overdoing initial multi-disciplinary consultations to maximise data returns from numerous touchpoints and produce a bulging dataset to realise efficiencies in pre-and-aftercare with authority.

Then deliver them gradually, as more is learned about the long-term physical impact of GLP-1s in tackling obesity ‘in the field’.

Maybe you think enough testing has already been done, that all boxes have been ticked. I would politely disagree.

What do I know? Not a lot. But GLP-1s feel like a neon anomaly in the world of medicine that demand far more attention than usual.

I know weight-loss jabs are already everywhere but they have hit the mass consumer market prematurely, like AI.

They have plural benefits, which, depending on what you read, are happening all the time.

And they have multiple drawbacks, which, depending on what you read, are happening all the time.

There is rapid weight loss, yes. Also pancreatitis. Concerns over impact on muscle and bone mass.

Those with eating disorders who find themselves both triggered and enabled.

Fresh gloomy clouds came courtesy of the MHRA this week.

Cheer up

Fortunately the TBI clears up any confusion quicker than a Wegovy patient drops a stone.

“As with all drugs, there are side effects,” it says, reaching for the blithest of medical cliches.

“The most serious of these, pancreatitis, is a potentially fatal condition that affected 0.2 per cent of patients in trials.”

That’s one in every 500 people. How do you like those odds?

And what about all the yellow cards weight-loss jabs have gathered?

“Recent data collected through the Yellow Card scheme in England showed higher-than-expected deaths in patients taking GLP-1s,” it says.

“Admittedly it is impossible to infer causality from Yellow Card data because of how “noisy” they are."

Noisy?

“That said, the findings do highlight the importance of ongoing research into GLP-1 use and the vital work of the MHRA in post-market surveillance.”

In a TBI version of football’s VAR, the yellow cards have been overruled by a think tank in London which thinks they are so noisy they drown out the bit about higher than expected deaths.

Not drowning, but waving.

Guzzling

Maybe obesity has grown so vast and amorphous that it needs a nuclear medicine-bomb to drop, complete with the shockwave radius it engulfs, helping out the heart, liver, kidney and lungs, before you even consider the positive impact on personal wellbeing and lifestyle.

Ignore all the years healthcare spent fighting for the UK to tackle rising obesity by following a healthier diet and exercise, now there is a jab for that, and you can order it from the sofa (inside 21 seconds!).

It’s a lot simpler than the years it took to force through a sugar tax to try and stop the guzzling of fizzy drinks, which now feels rather quaint.

Or maybe you are thinking ‘What’s the big deal? This is just a former PM opining. Put it in the corner with David Cameron’s thoughts on Brexit’.

It’s important because the report suggests this lightspeed digital weight-loss jab adventure should be handled by the TBI, rather than the DH or the NHS, and that the government outsources the weight loss jab mission to a TBI-team operating outside of government control, yet funded by it, to handle the biggest shift in UK healthcare, ever.

TBI calls for the TBI-team to have “direct, ringfenced funding from the Treasury and the power to evaluate, fund and deliver prevention activities differently.“

If those levels of funding are typically Treasury-like, the TBI’s non-profit status will be safe.

Though it does sound like the TBI has dreamed up a plan which sees it lead a government-funded privatisation of the most profitable drug-service on the planet.

Smart thinking. But is Tony Blair in a white coat what UK healthcare needs?

Riddled

I appreciate there is a vacancy of sorts. But before the DH and NHSE merger gets going…

Q: Will Blair’s plan help lots of people?

A: Yes.

Q: Does it promise impressive NHS cash-saving projections?

A: Yes – billions of pounds, easily enough to cover part of a fresh round of NHS pay-rises in Q3.

Q: Starmer is super keen on tech stuff at the moment – does it utilise AI?

A: Oh definitely. It’s riddled with it.

Q: Time-consuming expensive consultations?

A: No. It’s mobile-first. Frictionless.

Q: Okay – so we make everyone healthy and save shedloads of cash?

A: Almost everyone.

Rapid

TBI is not profit-led, but its vision for UK weight-loss appears to be.

No doubt the NHS could use some help in that direction. But is speeding it all up and making it far wider and more accessible the important thing right now?

Because if it is, this think tank has thought about it and delivered a cogent blueprint for a rapid rollout in every sense.

But if it was a good idea for pharmacists to speed things up they’d be doing it already.

There is a good reason they so infamously take their time.

Yes, obesity is a big and expensive drain on the NHS. And Mounjaro, Wegovy, Ozempic et al are a phenomenon.

The positive aspects of their power should be harnessed. They could affect NHS healthcare standards and finances in a tangibly positive way, and that really is saying something. But currently, are GLP-1s the bright green light solution proponents suggest?

Be wowed by the weight loss but look away from the damaged patients and deaths at your profitable peril.

And rather than appear to be prioritising the wellbeing of pharmaceutical manufacturing and online retail, think harder about the safety of patients, healthcare professionals, and the power of the medicines involved.

Then profit.