The Costs of Slimming Down

Given the impressive data on GLP-1 medications—highlighting both significant weight loss and meaningful clinical benefits for conditions like cardiovascular disease and diabetes—the media is abuzz. Transformational patient stories frequently appear on television and in print, and politicians are now advocating for the societal and economic benefits of these treatments in the UK. It’s all so promising, the future so bright

However, the question remains: how much of our taxes should the government or healthcare providers be willing to invest in these treatments?

Originally developed for Type 2 diabetes, GLP-1 drugs have shown remarkable efficacy in promoting weight loss. Clinical trials indicate that patients can lose up to 15% of their body weight on these medications. With obesity linked to severe health issues—such as heart disease, diabetes, and certain cancers—there is increasing interest in these drugs as a potential solution to the obesity epidemic

I have even heard talk of net savings to the UK plc. That is NET. SAVINGS. Now that’s a big BIG statement to make

So what is the financial cost? For the UK to facilitate the widespread use of these drugs, treatment costs must ideally correspond (or a least come close) to savings in healthcare expenditure and improvements in productivity that arise from reducing obesity-related illnesses

Let’s examine two groups treated over a 5 year period at current list prices (all the caveats apply concerning assumptions and uncertainty):

Firstly, the morbidly obese: This group, defined as having a Body Mass Index (BMI) of 40 or higher, comprises about 3% of the UK’s adult population—approximately 1.6 million people. They are disproportionately affected by severe health conditions, resulting in higher healthcare costs and economic losses due to absenteeism and decreased productivity

For this group, the estimated annual savings in healthcare and productivity from a 15% weight reduction maintained over five years could reach around ￡3.5 billion. These potential savings could potentially offset treatment costs at current list prices. Moreover, the quality of life and long-term health improvements for this group are substantial

Secondly, the obese population: A broader challenge lies in the larger group of obese individuals—those with a BMI of 30 or higher (minus those on or above 40)—who make up about 25% of the UK adult population (approximately 13 million people). The break-even point for this population is significantly lower. Here, annual treatment costs would need to be in the hundreds of pounds for savings to approach the costs of treatment which would be an eye catching ￡160 billion or so over five years or ￡32 billion per annum. To put that into context; the Chancellor of the Exchequer is currently looking to raise an additional ￡20-￡25 billion per annum in taxation to address the current shortfall and that is no easy task

This lower break-even point is due to the fact that, while obesity-related healthcare and productivity costs are considerable, they are less severe than those affecting the morbidly obese population. To justify significantly higher treatment costs for this wider group, the UK would need to demonstrate either much larger reductions in healthcare costs or productivity improvements beyond current estimates and supported by the available evidence

GLP-1 treatments may offer long-term health benefits that could further reduce healthcare costs in the future but the data will have to mature before we can be sure. But ultimately, the conclusion is clear: at current prices, these treatments should be made widely available to patients with the highest unmet medical needs, while others may need to bear the cost for themselves