(Bloomberg) -- Novo Nordisk A/S’s obesity shot Wegovy also prevents strokes, heart attacks and death. The price of those benefits is far higher in the US, where the cost of the drug has prompted a political outcry.
In the UK, the budget-conscious National Health Service spends less than half as much as US payers to prevent one of those health complications with Wegovy, even with discounts factored in, according to data analytics firm Airfinity Ltd. In Germany and Novo’s home market of Denmark, the bill is at least 25% lower.
The difference may be even bigger due to a lack of transparency over discounts, said Airfinity senior director Bhaskar Bhushan, who conducted the research. Wegovy’s list price is $1,349 a month in the US and £175.80 ($232) in the UK.
The discrepancy is riling up American lawmakers. Novo Chief Executive Officer Lars Fruergaard Jørgensen will testify in the US Senate on Tuesday about the high cost of both Wegovy and Ozempic, a version of the drug sold for diabetes. He’s previously said that as more insurers cover the obesity shot, the price will drop.
Positioning Wegovy as a powerful medicine for preventing heart attacks and strokes — not simply shedding pounds — is a cornerstone of Novo’s effort to get insurers to pay for it. But being effective isn’t enough to win over health systems: payers also want value.
“You always want to know whether, even if a medicine is effective at improving someone’s health, is it cost-effective for the health system to make that medicine available,” Bhushan said.
Airfinity last year estimated the cost of preventing one bad cardiac outcome at more than $1 million. The drug has been shown to lower the risk of strokes, heart attacks and cardiovascular death — known by the acronym MACE — by 20%.
Novo is also studying whether the drug can help across a range of other disorders, most linked in some way to weight or cardio-metabolic ill health. In one recent study, the shot reduced Covid-19 deaths in obese patients. In another, it improved knee pain from arthritis. In the latest development, European regulators will add language to the drug’s label saying that it can also reduce symptoms to improve the physical capabilities of people with heart failure linked to obesity, Novo said late Thursday.
$100,000 for a Year
But the cost of all these benefits has become a political hot potato in the US, where more than two-in-five adults suffer from obesity, and drug prices are among the highest in the world. Some insurers have argued that buying Wegovy for everyone who needs it will empty their coffers. Novo counters that insurers and middlemen in the US keep costs high.
Novo has pointed to Wegovy’s broad impact on health. In a company-sponsored study presented in May, researchers showed that Wegovy would be cost-effective at an average discounted price if regulators were willing to spend at least $100,000 for each additional year of health.
Instead of buying Wegovy, health systems would be better off pushing for broader use of cheap, older drugs such as cholesterol-lowering statins and blood pressure medicines, said Andrew Hill, a senior research fellow at the University of Liverpool, who studies the cost of drugs.
“In health economics, there’s this concept of opportunity cost,” Hill said. “A million dollars spent on one thing, like using Wegovy to prevent MACE, is a million dollars that you don’t have to spend on other things.”
Other Steps
In the UK, the drug review board NICE has concluded that in some cases Wegovy is probably worth the money. The NHS limits treatment to two years, however, and requires patients to access the drug via specialist weight-management services that can offer help from dietitians, physiotherapists and psychologists as well as physicians.
In Denmark, where the cost per heart attack prevented is roughly 50% higher than in the UK, a drug oversight panel said in June that Wegovy shouldn’t be a doctor’s first choice. The panel cited a high price for the drug’s outcomes.
But for patients, there’s a significant difference between Wegovy and a cholesterol-lowering medicine — they can see its impact on their bodies themselves, Airfinity’s Bhushan said.
“They might not care that much about 20% cardiovascular risk reduction,” Bhushan said. “It might just be, give me the strongest weight loss drug you have.”
(Updates with EU regulator in the eighth paragraph.)
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