An effective drug, but prohibitively expensive
The active ingredient in Wegovy, semaglutide, is not unknown. It is already used in Ozempic, a drug prescribed for type 2 diabetes. However, Wegovy is administered in higher doses and specifically intended to induce weight loss in obese patients. 18 phase 3 clinical trials showed an average weight loss of 12% to 17% of initial weight over a period of 68 weeks, results comparable to those obtained by bariatric surgery.
However, the question of price poses a problem. In France, Wegovy is sold at a price of between 9 and 12 euros per day, or around 300 euros per month, and it is not currently covered by Social Security. This high cost risks hindering access to treatment for the poorest patients. A situation which could improve if the High Authority of Health (HAS) decided to recommend its reimbursement, a process which is still under examination.
Strict rules to limit abuses
Wegovy belongs to the class of GLP-1 analogues, which act by mimicking a natural hormone to reduce appetite and promote the feeling of fullness. In the United States, Ozempic and Wegovy have been widely used, sometimes for cosmetic purposes, which has led to shortages and misuse. To avoid this in France, health authorities have imposed strict prescription conditions. The medication can only be prescribed to patients under 65 years of age suffering from severe obesity (BMI greater than 35), and only in the event of failure of prior nutritional support.
This vigilance is also explained by the fear of serious side effects, such as digestive disorders, pancreatitis or intestinal obstructions, which could occur in certain patients. These precautions are reminiscent of the abuses observed during the Mediator scandal, a drug prescribed as an appetite suppressant and which caused numerous deaths. Caution therefore remains necessary with GLP-1 analogues.
In Le Figaro, Professor Sébastien Czernichow, head of the nutrition department at the Georges Pompidou hospital, recalls that Wegovy, although effective, will not alone solve the problem of obesity, because its results vary from one patient to another. He considers this medication a valuable additional option, but emphasizes that it does not replace comprehensive care, including dietary, psychological and physical measures. Professor Martine Laville shares this opinion, comparing the treatment to a “crutch” to help certain patients modify lifestyle habits that are difficult to change.
On the other hand, taking this medication simply to lose a few pounds is not recommended due to its potential side effects if doses are increased too quickly. According to Professor Laville, Wegovy should not be perceived as an aesthetic product, but should be reserved for people suffering from obesity, a chronic illness, and not for people who are slightly overweight.
Adoption hampered by lack of reimbursement
If Wegovy is already a phenomenon in the United States, where 15 million patients use GLP-1 analogues, its adoption in France is hampered by the lack of reimbursement. “This will create inequality in access to care”deplores Anne-Sophie Joly, president of the national collective of obese associations for the JIM. On the one hand, those who can afford to pay several hundred euros per month to lose weight; on the other, those who do not have the financial means to access this treatment. An inequality that is all the more problematic as obesity affects nearly one in two adults in France.
The Novo Nordisk laboratory nevertheless hopes to obtain partial reimbursement for obese patients with comorbidities linked to their weight, such as diabetes or cardiovascular diseases. The results of the Select clinical study, which show a 20% reduction in major cardiovascular risks, could support coverage by Health Insurance.
Discreet links with experts and associations
Novo Nordisk hopes to capitalize on Wegovy to make it a commercial success. By banking on the promise of fighting obesity on a global scale, the company has already attracted investors. So much so that its capitalization has quintupled in less than 4 years and now exceeds Denmark’s GDP. Les Echos Études estimated in 2023 that the French market for anti-obesity drugs could approach 4 billion euros by 2030, according to the median scenario.
The pressure is therefore strong and Novo Nordisk’s commitment to promoting Wegovy in France is not limited to marketing campaigns. According to Le Canard Enchainé, the laboratory has established links with several influential medical experts, associations and learned societies. The palmiped regrets, for example, that Professor Sébastien Czernichow, whom we cited previously, publicly salutes in Le Figaro the benefits of this treatment, without mentioning the 40,000 euros that he would have received from the laboratory since 2022 for his support on the medical strategy. economics of the company.
“When we talk about other chronic illnesses, we don’t ask ourselves the question of reimbursement for medications: we reimburse them. Why should it be any different with obesity? » Professor Sébastien Czernichow in Le Figaro.
Certain influential associations, such as the National League Against Obesity (LCO), the Heart Alliance and the European Society of Cardiology, have also benefited from significant funding from Novo Nordisk. The LCO would have received more than 104,000 euros in 2024, the Heart Alliance 20,000 euros in 2022, and the European Society of Cardiology one million euros in less than two years. These financial contributions cast doubt on the independence of these organizations, especially since, as the satirical newspaper points out, they do not systematically mention them in their communications.
Progress under conditions
The arrival of Wegovy in France marks an important step forward in the fight against obesity, but it is surrounded by numerous obstacles. Its effectiveness in weight loss is undeniable, but its high cost, the very strict prescription conditions and the lack of transparency on the financial links between the laboratory and certain experts and associations limit its accessibility. For the moment, only patients who can afford to finance the treatment will benefit from this new solution, while waiting for the authorities to decide on the question of reimbursement.
If Wegovy manages to be reimbursed by Social Security, it could become a key tool for treating obesity and its complications, while reducing inequalities in access to care. However, the caution of health authorities, in a post-Mediator context, underlines that this drug, although promising, is not free of risks. The future of Wegovy in France will therefore depend on the regulator’s ability to balance its medical benefits with its economic and ethical constraints.
