Weight-loss medicine excluded from reimbursement, risks unequal access, says company
The lack of reimbursement for obesity drug Wegovy is a missed opportunity that risks increasing inequality in access to care and encouraging unsafe use, said manufacturer Novo Nordisk on Thursday.
The comments follow Belgian health minister Frank Vandenbroucke (Vooruit) confirming on Wednesday that Wegovy will not be reimbursed in Belgium. He followed the advice of the medicines reimbursement committee within RIZIV/INAMI, although he described the decision as “not straightforward”.
Wegovy, based on the active substance semaglutide, mimics the GLP-1 hormone produced in the gut, helping regulate appetite and slow gastric emptying, thereby reducing weight. However, medical experts note that weight is typically regained after stopping treatment, and side effects such as nausea, diarrhoea and vomiting are relatively common.
Health system and cost concerns
Vandenbroucke warned that widespread reimbursement would have major budgetary consequences. Previous estimates suggest that if all eligible patients were treated, annual costs could reach billions of euros, potentially exceeding half of Belgium’s total medicines budget. He also argued that such spending would displace other necessary care.
“Obesity is a chronic disease that, just like all other chronic diseases, deserves the best and, above all, the right care,” Vandenbroucke said, noting that long-term treatment must be embedded in broader care pathways involving physiotherapists, dieticians, psychologists and lifestyle support.
“The question is not whether Belgium can afford to reimburse an obesity treatment, the question is whether Belgium can afford not to do so"
He added that uncertainty remains over the long-term benefits once treatment stops, making it difficult to assess the overall value of reimbursement at the population level.
Novo Nordisk countered that investing in obesity treatment would reduce future hospital admissions, complications and disability. “The question is not whether Belgium can afford to reimburse an obesity treatment, the question is whether Belgium can afford not to do so,” the company said, adding that without reimbursement, only patients with sufficient financial means would have access.
The company is calling on policymakers, healthcare providers and patient organisations to continue discussions on possible solutions.
Several GLP-1-based medicines, including Ozempic, Rybelsus, Trulicity, Victoza and Xultophy, are already reimbursed in Belgium for the treatment of type 2 diabetes. Since 1 February, reimbursement conditions have been tightened, requiring prior approval from health insurers. The drug Mounjaro has already been subject to specific reimbursement rules for some time.
© PHOTO THIBAUT DURAND/ ABACAPRESS
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