Irish head to the North for weight-loss jabs

Desperate patients are heading to the North to get their hands on the weight-loss drug Wegovy before its expected arrival in the Republic next year.
The injectable prescription medication for adults who are obese or overweight is produced by Novo Nordisk, a Danish pharmaceutical company, and was approved for use in Ireland in March 2022. But production problems and high demand for the medication in the US, where it has been available since 2021, have led to delays in its launch in Ireland and elsewhere in Europe.
It is now available in the UK, Germany, Denmark, Norway and Switzerland. In the UK, Wegovy costs the equivalent of €197 a month for the starting dose and up to €348 for maintenance doses.
Wegovy is identical to Ozempic, another injectable drug from the same maker that is licensed in Ireland to treat type 2 diabetes. Ozempic can be prescribed off-licence to treat obesity, but at half the dose of Wegovy.
An update on the US Food and Drug Administration website this month showed that more doses of Wegovy were in stock after years of shortages, which is considered positive for countries that still await the medicine.
Dr Illona Duffy, a GP in Co Monaghan, said she was aware of Irish patients buying Wegovy in Northern Ireland, but at a high price. “Initially some of the pharmacies [in Northern Ireland] were actually providing it when patients went in and had a consultation, but without needing a doctor’s consultation,” she said.
“I think that dried up because we had a few patients that were going across the border and getting it, but then that seemed to stop because then they were contacting us about it. Some people living along the border can also get it prescribed by GPs [in Northern Ireland] as some still have addresses on both sides.
“Theoretically, patients can go and buy it. But the reality for a lot of them, when they hear the price, they’re thinking, ‘oh, that’s OK, I can afford that for a little while’ — they’re forgetting that this is a lifelong drug.”
Mick Crotty, an obesity medicine specialist and co-founder of My Best Weight, said he was aware of Irish doctors who prescribed Wegovy for patients to buy across the border. “There are many patients who are sold Wegovy in Northern Ireland with prescriptions from the Republic,” he said.
Donal O Shea, the HSE clinical lead for obesity, said the hope was that Wegovy would become available in Ireland next year.
He said: “I’ve met Novo Nordisk and I’m hoping that Ireland will get doses earlier than other countries because the World Health Organisation [WHO] are interested in the Irish model of care and how we’re attempting to prevent and treat obesity.
“I think the company will be encouraged to launch in Ireland before they launch in other countries because Ireland is one of the few countries that is including it for reimbursement and providing it on the medical card scheme.
“The WHO are absolutely keen that obesity is treated not just for the people who can afford it but the people who are more affected by it, which are people who are less well off. There is that socioeconomic trend with obesity.”
O Shea said that the WHO was to bring a delegation to Ireland in January from three countries, which he hoped would encourage Novo Nordisk to launch Wegovy here.
“We’re trying to use the WHO’s interest in our model because they want Ireland to be a demonstration platform for other countries,” he said. “It’s the first time the WHO has had a demonstration platform around a disease and we’re hoping to use that to leverage two things. We’re hoping the company will launch early in Ireland because of the WHO involvement and we hope it will get the government to commit to the full funding for a model of care as at the moment our model of care is only 50 per cent funded.
“Basically, we’re hoping the WHO interest will speed up the launch of the product in Ireland.”
Duffy said it was important to remember that Wegovy and Ozempic were not suitable for everyone. “We have to remember there are risks with it and there are side-effects with it,” she said. “It’s interesting that even on social media you’re seeing more highlighting of that and people saying, ‘I wish I’d never started because of the side effects and continued side effects’.
“This isn’t something you take just to lose a half stone before a wedding. There’s the fear out there among the HSE that this is what people are going to want it for and seek approval for.”
Crotty agreed, saying there was still concern that people who were not living with obesity were trying to buy Wegovy and similar medications.
“There are many people who don’t have an impairment of health that are using them more for weight loss which is not what the medications are designed or intended for,” he said. “That’s another issue that probably is contributing to some of the shortages of these medications too.
“There is probably a lot of work for us to do as far as educating healthcare practitioners about these medications and how they work and why they work, as well as who they should be prescribed for.”