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Novo’s blockbuster obesity drug Wegovy under fire in Denmark

A packet of Wegovy at the Novo Nordisk A/S production facilities in Hillerod, Denmark.   (Carsten Snejbjerg/Photographer: Carsten Snejbjerg/)
By Sara Sjolin </p><p>and Naomi Kresge Washington Post

A Danish drug oversight panel advised doctors to restrict prescriptions of Novo Nordisk A/S’s blockbuster obesity drug Wegovy, saying the medicine is so expensive that it would cost about $870,000 to prevent a single heart attack, stroke or other severe cardiac problem.

Wegovy shouldn’t be a doctor’s first choice, and they should only start a “few” patients on the treatment, the Danish Health Authority’s Institute for Rational Pharmacotherapy said in a report released on June 6. Though the institute is influential, doctors have wide leeway to disregard its advice.

Denmark, Novo’s home market, is among a growing number of places where experts are pushing back on Wegovy’s cost despite its impact on weight loss and a host of related ailments. In the U.S., Michigan’s largest health insurer said Wednesday it will drop coverage of the new obesity drugs starting in January. Though the treatment works well for weight loss, patients also shed muscle, and there’s little data on long-term effects for those who stop the medicine, the Danish institute warned.

A record number of Danes are being treated with Wegovy. Almost 80,000 people in the Nordic country of 6 million are currently using the drug, which has been on the market since 2022. The medicine costs about $340 a month in Denmark, compared with a list price of about $1,350 a month in the U.S.

Wegovy’s impact beyond weight loss – on heart disease and other ailments linked to obesity – is a core part of Novo’s argument for why insurers should cover the drug.

‘Uncertain effect’

In Denmark, most patients pay for it themselves, with public insurance picking up the tab only for the most serious cases. But even so, the health authority argued that the cost doesn’t match the benefits. To avoid a cardiovascular event, 65 heart patients would need to be treated for four years, the report said, bringing the total cost of preventing a single heart attack to about 6 million kroner ($870,000).

Novo disputed the conclusions, saying in a statement on Thursday that other experts including the U.S. Food and Drug Administration view the drug’s clinical-trial results differently. Novo said it would review the report and “hope to enter into a dialog with the Danish Health Authority.”

The Danish institute said that Novo’s keystone trial of Wegovy in patients at heart risk hadn’t shown a big enough difference, advising that obese patients with cardiovascular diseases should not be treated with the Novo drug as a first choice.

People who took Wegovy in the study were 20% less likely to suffer a cardiovascular event than those who got a placebo, but the agency said a high dropout rate may have biased the results and that it was a limitation that most of the volunteers in the study were men.

This is a “high price, with little and uncertain effect in the high risk population,” the health authority said.

The Danish approach is in contrast to the US, where the FDA in March approved the use of Wegovy for reducing the risk of major adverse cardiovascular events. Novo has an application for a similar label expansion under review at the European Medicines Agency.