Weight Loss Medication

Question

14:58:00

Asked by

To ask His Majesty’s Government what plans they have to make weight loss medications available to people living with obesity who are unable to afford them privately.

My Lords, in begging leave to ask the Question standing in my name on the Order Paper, I declare something of an interest, in that I have used them and they work.

I look forward to the noble Baroness’s testimony. The obesity medicines Wegovy and Mounjaro are already available to eligible patients attending NHS specialist weight management services. In June, the NHS began making Mounjaro available through primary care. Around 220,000 adults will be considered for Mounjaro in the first three years, access being prioritised by clinical need. We are committed to expanding NHS access and will work closely with industry and local systems to identify innovative ways to do this.

I thank the Minister for her Answer. Credit where it is due: achieving that number of people benefiting from weight loss jabs is absolutely terrific. I challenge the Minister—not her personally but the Government—to be a little more creative, in that there are people in this country who cannot work because of conditions resulting from obesity. If we added up the money we spent on government programmes and different drugs to compensate for that, and then looked at the cost of the drugs, we would see that it is worth a pilot scheme, to be a bit more creative; otherwise, we will know the cost of everything and the value of nothing. Will the Minister talk to our friend, the noble Baroness, Lady Sherlock, in the DWP to see whether we can get a pilot going?

I think it is fair to say that everyone knows how significant this is, not only the personal cost of not helping people, but the cost to the NHS, the economy and wider society. The truth is that around 3.4 million adults in this country could be eligible. From talking to ICBs, we know that rollout on that scale has to be taken very seriously so that the systems do not fall over. It is a priority. Other weight-loss methods are ongoing and will continue alongside, but it is something we will continue to work exceptionally hard to achieve.

My Lords, I too am a user of Mounjaro, and I also helped facilitate the introduction of continuous glucose monitoring into the NHS. Is it not a fundamental problem that the current process of the National Institute for Health and Care Excellence is far too short-term? It puts too much weight on short-term cost savings to the NHS and not enough on long-term analysis of the benefits to the economy and of things such as emotional well-being, which is priceless.

I completely concur with the noble Lord’s last comments. Issues around weight and food choices are exceptionally complex, but the impact on emotional health is enormous. We have to work with the systems and the life sciences sector to make sure that we do proper longitudinal studies that can help NICE in its decision-making process. I cannot comment on NICE’s procedures around this, but it is regarded as an absolute priority by everyone involved.

My Lords, should we ask the food industry, which is responsible for obesity, to pay a contribution so that we can extend this service?

My noble friend is right that there is a lot of attention on the food industry, and that is why so many programmes are now being targeted against advertising to children, et cetera. We will continue to work to make sure that that industry takes due regard of the impact of its products, and to do everything we can to improve regulation.

My Lord, one of the problems we have is that a number of medicines that are available privately are not available on the NHS. I am thinking in particular of medicines for prostate cancer. I happen to know that the DHSC is currently looking at a regime for them. Perhaps the Minister could look at the United States, where, at least in some states, there is a limit on the amount of profit that can be taken from privately supplying medicines—in other words, a costing regime—and also at whether the range of consultees on this matter could be slightly widened to include some noble Lords in this House who have been writing to the department for about six months now attempting to get a dialogue going.

The noble Lord is right that interest in this area from this House and the other House has been very high. I think it is because of the progress that has been made. Of course, everyone looks at practice, in this country and other countries, to inform how we work. There is no doubt that those who can afford to pay to have access privately are seeing a significant difference. We want to make sure that we move forward so that the treatment is available for everyone.

My Lords, I think everyone welcomes the advent of these drugs for people who have serious weight problems, but what happens when they come off them, and what are the Government doing to ensure that we have a much healthier diet available to people of any income, wherever they are? Quite frankly, if your diet becomes one Coca-Cola and one hamburger rather than five times that, it will not fix your health in the long term. It might get your weight down, but you will still be, essentially, a malnourished human being.

There is no doubt that, when these injections are working alongside other weight management approaches, including education around diet generally as well as exercise, the chances of success on all the issues that the noble Baroness raises are far greater. We need to understand the longer-term impacts of being on these drugs—whether it will be safe for people to be on them for longer. We need to understand the challenges as well as the opportunities. There are opportunities coming forward for other areas of medicine from the use of these drugs.

My Lords, I want to follow up on what the Minister has just said and the previous question from the noble Baroness. As we have heard from the personal testimonies of noble Lords, these medications have the potential to reduce obesity and the long-term cost to taxpayers. Unfortunately, a recent study by the MHRA has found that a group of these drugs, including Mounjaro, Wegovy and Ozempic, may be associated with health problems such as inflammation of the pancreas. Given that, and some of the previous questions, first, what assessment of the long-term impact on health have the Government made of these weight-loss medications? What data do they have as of now, and what data are they waiting for? Secondly, as the noble Baroness, Lady Boycott, said, how do we ensure that, when patients come off these medications, they do not just put all the weight back on? How do we make sure that they are part of a wider programme to keep the weight off?

Quite a few points were made there. I think the noble Lord is referring to reports about acute pancreatitis, for example. The MHRA has done a thorough review of the suspicions around these medicines. No new safety concerns were identified but, every time something comes up, it will be looked into. The noble Lord is absolutely right that we need to support the longitudinal studies that are happening, but going on beyond the initial licensing will also be critical. As I answered previously, work in other areas to encourage healthy lifestyles will be ongoing, and this will need to be taken seriously by patients from a very young age.

My Lords, the causes of obesity are many, not just one or two issues. Has my noble friend the Minister considered whether some sort of pilot programme looking at particular types of obesity might be sensible, just as the questioner has, in effect, already asked? I agree that the long-term effects are really important and must not be forgotten.

My noble friend raises an important point. I would not stand at the Front Bench and counter what he has said. I will be very happy to pick up his ideas after this session and look at all the innovative ways in which we can take future work forward.

I congratulate the noble Lord, Lord Watts. For once I find myself in complete agreement with him. Is he not right in saying that we should be tackling the causes not the symptoms, and that the causes lie with food manufacturers, which deliberately produce products that are addictive and processed, and form the cheaper foods diet of people in our country? The time has come to take action other than just trying to prevent advertising to children.

I am delighted to hear the intervention from the other Benches. This is something to be welcomed. Obesity is complex. I would not like to stand here and put it down to one cause. There are multiple causes, as we heard earlier, around mental health and so many other issues. Everything needs to be on the table. It is a serious issue, costing this country, and other countries around the world, dearly. We need to look at every possible outcome.