The Tony Blair Institute today (May 20) called for “faster, broader access” to weight loss medicines via a “means-tested” rollout through private providers already offering the drugs.
Currently, both Mounjaro and Wegovy are recommended on the NHS for those with a body mass index (BMI) of more than 35 and at least one weight-related illness, but bricks-and-mortar and online pharmacies can only provide them privately.
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In a new report, the “not-for-profit, non-partisan organisation” said that NHS eligibility for the anti-obesity medications (AOMs) should be widened to all those with a BMI of 27 or above and rollout should be “targeted at those of working age over 40”.
The report also recommended this wider rollout take place “predominantly through digital channels”, in particular online pharmacies, saying that rollout at scale through general practice is “probably both infeasible and unreasonable”.
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“As long as strict clinical governance standards were set, the NHS could expand access to AOMs far faster than under current plans by commissioning private-sector providers to deliver weight management services using established digital-first delivery mechanisms,” it said.
These providers of “direct-to-consumer” weight loss services should “already prescribe AOMs, have national reach, offer both digital and in-person services and adhere to agreed clinical-governance and data-governance standards”, it added.
The rollout could “proceed at speed by agreeing national contracts with a handful of private providers” meeting these criteria, meaning “only five or so contracts would need to be maintained”, it said.
Online pharmacy “concerns”
The report admitted that there have been “concerns about the level of wraparound support provided by private online pharmacies”, such as advice on diet and exercise as well as psychological support.
“In addition, some online pharmacies are flouting rules around the advertising of prescription-only medications (POMs),” it said.
But it stressed that “the fact that they are operating at scale and at a fraction of the price of the NHS cannot be ignored”.
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“Given that the private sector has already made the leap to these digital-first delivery models, why is the NHS reinventing the wheel by doing three years’ worth of pilots,” it said.
The report also set out that the programme could be “delivered using existing contracts and data-exchange mechanisms” such as the Pharmacy First contract and GP Connect technology “in the first instance”.
But it added that other providers should also be commissioned over time and a new “bespoke” data-exchange platform established that connects to patients’ digital health records and the NHS App.
“Means-tested”
The report also recommended that access to free treatment be “means-tested”, with those not eligible for free prescriptions either paying themselves or sharing the cost with their employer.
And it pointed to the “relatively under-regulated private market” and “smaller but not insignificant illicit market” as a “a good case for broadening access to legitimate AOMs through safe, affordable means”.
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Recommendations also included that:
- The programme should be delivered by a “new function within government” - dubbed “Protect Britain” - that would lead on prevention efforts with “ring fenced funding” from the Treasury
- Costs could be “contained by reaching a negotiated price settlement with pharmaceutical companies”
- Weight management services should be made available via the NHS App, with a “unique NHS identifier” for each individual so patients can “validate their NHS identity with accredited providers”
- Uptake of the service should be promoted through the expansion of the UK’s Health Check programme
- Patients should be able to “self-refer to weight-management services at any age if they are eligible”
- Employers should have access to a list of accredited providers with “access to drugs at a lower unit cost than the market price”
- Clinical and data governance standards should be set “above and beyond regulator standards if deemed necessary”, such as mandatory notification of a patient’s GP when they are initiated on treatment or standards on “how many Yellow Card notifications” are expected
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The report’s authors thanked various industry insiders for their “input and feedback”, including employees at Boots, Asda, Tesco and online pharmacies Pharmacy2U, Juniper UK and Simple Online Healthcare, as well as the Company Chemists’ Association (CCA).
However, it stressed that “contribution does not equal endorsement of points made in the paper”.
The CCA today said that it is “delighted to have shaped this timely report” and stressed that community pharmacies “would be well placed to deliver wraparound weight loss care, to increase access where needed”.
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It comes as multiple claims around weight loss drugs have been raised with a pharmacy insurer, including one after a patient had to have their gallbladder removed.
And reports this month claimed that a multimillion-pound deal “with a major pharmaceutical firm” is set to fund a national NHS weight loss jab prescription pilot in pharmacies.
Meanwhile, C+D this month revealed that one online pharmacy’s funds boomed almost 600% in just six months thanks to the thousands of weight loss scripts it processes every month.
