The Medicines and Healthcare products Regulatory Agency (MHRA) has given its approval for the UK's first GLP-1 receptor agonist tablet designed for weight loss and management. This oral form of semaglutide, marketed as Wegovy, can now be prescribed to adults who are obese, defined as having a Body Mass Index (BMI) of 30 or above. It is also available for individuals who are overweight with a BMI between 27 and 30 and have at least one weight-related comorbidity.
Julian Beach, Executive Director of Healthcare Quality and Access at the MHRA, confirmed that the semaglutide tablet met the agency's stringent standards for safety, quality, and effectiveness. The medication works by mimicking a naturally occurring hormone, glucagon-like peptide (GLP-1), which is released after eating. By acting on brain areas that regulate appetite, it helps individuals feel fuller for longer, reduces hunger, and decreases food cravings, thereby supporting weight reduction when combined with a reduced-calorie diet and increased physical activity.
Patients will begin with a daily dose of 1.5 mg, which can be gradually increased to 4 mg, 9 mg, and then 25 mg, with a minimum of one month at each dose level. Those currently receiving a weekly 2.4 mg semaglutide injection privately can transition directly to the 25 mg daily tablet. However, it is crucial to follow specific instructions for taking the tablet, including consuming it whole on an empty stomach after an eight-hour fast, with no food or drink for at least 30 minutes afterwards, to ensure optimal absorption.
While this oral treatment has received regulatory approval, it is not yet accessible through the National Health Service (NHS). Decisions regarding its availability on the NHS will follow established processes, including a comprehensive evaluation by the National Institute for Health and Care Excellence (NICE). This evaluation will assess the drug's cost-effectiveness and overall benefit to patients and the healthcare system, a critical step before widespread public access.
The economic implications of such a widely anticipated treatment are significant. For private patients, the cost of this prescription-only medication will be a direct expense, potentially running into hundreds of pounds per month, which could impact household budgets. Should NICE recommend its use on the NHS, the cost to the public purse could be substantial, potentially reallocating funds within the healthcare system. Conversely, successful weight management at a population level could lead to long-term savings by reducing the incidence and severity of weight-related conditions such as type 2 diabetes, heart disease, and certain cancers, which currently place a considerable burden on NHS resources.
Common side effects associated with the semaglutide tablet include gastrointestinal disorders such as nausea, diarrhoea, constipation, and vomiting. The MHRA will continue to monitor the safety and effectiveness of the medication closely, encouraging users to report any suspected side effects through its Yellow Card scheme.
Source: Medicines and Healthcare products Regulatory Agency (MHRA)