Novo Nordisk's Wegovy gets a boost in the U.K.

England’s drug cost watchdog NICE has recommended Novo Nordisk’s Wegovy to reduce the risk of heart attacks and strokes in people who have already had a cardiovascular event, making it the first GLP-1 drug backed for that purpose in the U.K. and potentially extending access to around 1.2 million people.

The guidance applies to adults with a prior history of heart attack, stroke, or peripheral arterial disease — a condition affecting circulation in the legs — and a BMI of 27 or above. That threshold is lower than the one currently used for NHS access to Wegovy for weight loss, meaning the decision opens the drug to a different and broader patient group. Patients receiving Wegovy for this indication will also be expected to follow dietary changes and increase physical activity, and the drug can be used alongside standard cardiovascular medications including statins.

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The decision is based on results from the SELECT trial, in which 17,604 participants taking semaglutide alongside standard care were 20% less likely to experience a serious cardiovascular event than those receiving a placebo. NICE noted that the cardiovascular benefit appeared early in the trial, before significant weight loss occurred, suggesting the drug acts on the heart and blood vessels independently of its effect on weight.

Novo Nordisk said Wegovy will be incorporated into existing cardiovascular care pathways, allowing doctors to consider it as an additional option alongside standard treatments. “It means clinicians in England now have access to a further treatment that NICE has found to be cost effective, the first and only GLP-1 receptor agonist proven to reduce the risk of heart attack, stroke or cardiovascular death in this high-risk population,” Sebnem Avsar Tuna, general manager at Novo Nordisk U.K., said in a statement.

NHS England said the drug is expected to be available through the health service within months, according to Bloomberg. Patients will not be automatically prescribed Wegovy — a GP or specialist will assess individual eligibility.

The approval gives Novo a positive signal at a difficult moment for the company. Novo has lost market share to rival Eli Lilly $LLY -1.98%, whose weight loss medicines have produced more pronounced results at approved doses, and the company faces pricing pressure in the U.S. as well as generic competition in some markets. Wegovy had already received U.K. regulatory approval in 2024 for cardiovascular risk reduction, but access on the NHS was limited to patients paying out of pocket for that indication, according to CNBC.

NICE said semaglutide’s cost per unit of health benefit came in within the range the agency considers acceptable, and that it “provides benefits and value for money, so it can be used routinely across the NHS.”

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