Availability of GLP-1 Receptor Agonists (GLP-1 RAs) for managing obesity

The prescribing of GLP-1 RAs (Wegovy® and Saxenda®) for obesity in primary care goes against the recommendation of NICE (and is not supported by North East London ICB).

 These drugs are currently not available via the Homerton Healthcare (Tier 3) Specialist Weight Management Service OR (Tier 4) Bariatrics.

There is a national shortage of GLP-1 RAs, mostly due to increased demand for these products for licensed and off-label indications. Supplies of Saxenda® (liraglutide) are expected to stabilise to meet full market demand by mid-2024 and supplies of Wegovy® (Semaglutide) have not been made available in the UK by the manufacturer.

At this time, it is imperative that all GLP-1 RAs (prescribed by brand) are ONLY prescribed for the treatment and management of Type 2 Diabetes. This is in the interest of patient safety for existing patients already on these medications and to lessen impact on GLP-1 RAs national shortages. NEL ICB does not support the off-label use (including weight loss) of Ozempic®, Victoza® or other GLP-RAs outside of product licenses. 

• Practices are advised to decline private recommendations to prescribe GLP-1 RAs for management of obesity to ensure that these drugs are utilised in line with NICE guidelines ^1,2 (i.e. drug is prescribed within the context of a specialist weight management programme so patients receive longer term lifestyle, dietary and psychological support). 
• The NEL Pharmacy and Medicines Optimisation Team, shared the following position statement on GLP-1 RAs (Wegovy® and Saxenda®)  for the management of obesity, which practices should refer to: https://primarycare.northeastlondon.icb.nhs.uk/wp-content/uploads/2023/06/GLP-1-analogue-position-statement-NEL-v1.pdf 

References:

1. NICE (2023), Semaglutide for managing overweight and obesity, accessed on the 28/3/23 and available at: https://www.nice.org.uk/guidance/ta875/resources/semaglutide-for-managing-overweight-and-obesity-pdf-82613674831813¹
2. NICE (2020), Liraglutide for managing overweight and obesity, accessed on the 28/3/23 and available at: https://www.nice.org.uk/guidance/ta664/resources/liraglutide-for-managing-overweight-and-obesity-pdf-82609259121349²
3. National Patient Safety Alert – Shortage of GLP-1 receptor agonists: CAS-ViewAlert (mhra.gov.uk) 

Any queries can be directed either nelondonicb.prescribingqueries@nhs.net (Medicines Optimisation Team)

or tendy.kwaramba@nhs.net (Programme Management)