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Danish pharmaceutical giant Novo Nordisk has launched its flagship anti-obesity drug Wegovy in France – but it can only be prescribed in a very limited number of cases, meaning that people who want it to lose weight will have to pay the entire cost themselves.
Pharmacies will be able to purchase Wegovy for between €208 and €220 for a box of four injections – enough to cover treatment for one month, according to Philippe Besset, President of the French Federation of Pharmaceutical Unions (FSPF), in Le Parisien. This represented, he told the paper, an estimated retail price, “between €270 and €330 per box, including 10 percent VAT.”
It will be available to buy from pharmacies, but patients will have to pay the entire cost themselves, with no reimbursement from the public health system.
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It’s unusual for a pharmaceutical company to market a drug in France that is not available for reimbursement on the public health system.
Even though obesity affects about 14 percent of the French population, the drug will only be available under a restricted framework by French medicine safety watchdog the Agence Nationale de Sécurité du Médicament (ANSM).
Wegovy works like its more famous brand-sister product Ozempic, which was originally developed as an anti-diabetic drug. To treat obesity it is used in higher doses.
Prescription
In France, the drugs are primarily considered to be treatments for inadequately controlled Type 2 diabetes and, according to Assurance Maladie “have no indication in the management of obesity”.
This means that the drugs will usually be reserved for certain diabetic patients, with their GP’s approval.
The ANSM said in a press release that the use of this type of drug as a treatment for obesity is restricted and can only be prescribed as a treatment by specialists in endocrinology, diabetology or nutrition.
Once prescribed by a specialist, GPs may renew the prescription - people who have Wegovy prescribed will have a percentage of the cost reimbursed by the state, via their carte vitale in the usual way.
The Haute Autorité de Santé (HAS) recommends that these drugs should be used only as an obesity treatment for patients under the age of 65 who have a body mass index greater than or equal to 35 kg/m2 – and only as a second-line treatment, in the event of failure of nutritional management, and in association with a low-calorie diet and physical activity.
Risk warnings
ANSM has already issued a warning to the French public of the risks of improper use of such drugs, after celebrity advocates including Oprah Winfrey and Elon Musk touted their effectiveness for quick weight-loss
In June 2023, it said that users risked serious adverse effects, such as “pancreatitis, intestinal obstruction [or] gastroparesis”. And, a year later, it again warned that they should, “not be used for cosmetic weight loss … in people without obesity or in overweight people who do not have weight-related health problems.”
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The most frequently reported side effects of Wegovy are nausea, diarrhoea, constipation and vomiting. Less frequently, the drug can also cause dizziness, headaches and hair loss.
The recommendations may change pending further medical trials. A total 7,048 patients with at least one weight-related comorbidity, such as hypertension, dyslipidemia, cardiovascular disease or sleep apnea syndrome took part in a trial between July 2022 and September 2023.
ANSM said that “a longer-term follow-up of these patients will enable us to assess the evolution of the different usage profiles in the context of its marketing [as an anti-obesity drug]”.
