Since last spring, Novo Nordisk, which markets Wegovy, has been negotiating with the regions and TLV about what a possible subsidy could look like, but it has now been rejected.
Patients who are prescribed Wegovy for obesity and who do not have type 2 diabetes are currently responsible for the entire cost themselves. Depending on the dose, it can be up to 4,000 SEK per month.
Applied for a smaller group
Novo Nordisk had applied for a subsidy for Wegovy for a defined patient group with a very high body mass index (BMI) and several concomitant diseases.
But TLV fears that the drug will be used for more people. They state that around 1.6 million people fall within Wegovy's scope of use.
"There is a huge demand for these drugs and we have no way of following up that they reach the right patients. There are no such registers with information about BMI or comorbidity," says Per-Henrik Zingmark, head of unit at TLV.
Last year, Wegovy was sold for around 675 million SEK outside the benefit system. Since the cost of the drug is high, it is estimated that there will be major financial consequences for the state and regions if the drug is used for patient groups other than those with the greatest need.
Surprised and disappointed
Jenny Vinglid, Secretary General of the Swedish Obesity Association, is disappointed.
"It is surprising, and I am very disappointed. It will affect the patient group above all, but it will also affect the view of obesity in the future. We have a drug that meets the authorities' requirements, but we still get a rejection. Don't you trust your own system?"
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Ylva Trolle Lagerros, professor at the Karolinska Institute and chief physician for obesity in the Stockholm Region, sees distrust in doctors' ability to prescribe medication to the right patients.
"The TLV is going to look at whether the drug is cost-effective and works, but here they are adding a completely new parameter: will the doctors behave? That's strange. It's not difficult to interpret which patients are meant," she says.
She believes that this ultimately leads to increased inequality.
"It will be those with money who can afford treatment."
Novo Nordisk believes that subsidies for specific groups are possible.
"Limiting prescriptions within the benefit to certain patient groups is not unusual in Sweden and works well in other disease areas. We believe that it would be entirely possible to offer a limited group of patients with the greatest medical needs treatment within the benefit system with high-cost protection," says Maria Eklind, Medical Director for Novo Nordisk Sweden, in a press release.
Petra Hedbom/TT
Mikael Widerberg/TT
Facts: GLP-1 drugs
TT
Wegovy is a GLP-1 drug. GLP-1 drugs with the substances semaglutide and tirzepatide were developed for people with diabetes and are sold by prescription under the brand names Ozempic and Wegovy (semaglutide) and Mounjaro and Zepbound (tirzepatide).
Medications are also effective against obesity, as they affect hunger signals to the brain and slow down the rate at which a person's stomach empties, making the feeling of fullness last longer.
GLP-1 (Glucagon-like peptide-1) is a natural hormone that helps maintain normal blood sugar levels. GLP-1 is released in the body after eating and stimulates the pancreas to release insulin when blood sugar is high. The current medicines imitate the body's own hormone GLP-1, which is released in the gut when you eat.
