Switzerland is experiencing a significant health crisis among diabetes patients, with inadequate treatment and rising medication costs, particularly for Ozempic, which has surged over 40% since 2020. The popularity of Ozempic, often used for weight loss, raises concerns about prescription practices. Novo Nordisk’s new medication, Wegovy, approved for obesity treatment, may alleviate some issues but comes with restrictions. Despite potential cost increases, these GLP-1 therapies could reduce overall health expenditures by addressing obesity-related conditions.
Health Crisis Among Diabetes Patients in Switzerland
Switzerland is facing a concerning health situation, as numerous diabetes patients appear to have been inadequately treated for several years. This alarming observation is highlighted in a recent pharmaceutical report released by the health insurance provider Helsana, which shows a remarkable increase in the cost of diabetes medication. Since 2020, expenses have surged by over 40 percent annually.
The Rise of Ozempic and Its Implications
The spotlight is on a drug named Ozempic, which has become increasingly popular in recent years. Last year alone, over 81,000 patients utilized their basic insurance to cover Ozempic prescriptions. However, it’s important to note that insurance coverage is limited; health insurers are only authorized to reimburse Ozempic for the treatment of type 2 diabetes, as per the Federal Office of Public Health (BAG) regulations.
Helsana confirms adherence to these guidelines. Manuel Elmiger, a health economist at the company, stated, “Our specialists ensure that the reimbursement aligns with the established guidelines.” Yet, questions arise regarding the appropriate prescription practices for Ozempic. While its global popularity has soared, this is largely attributed to its appetite-suppressing side effect, which facilitates weight loss. Celebrities such as Oprah Winfrey and Robbie Williams openly share their experiences using Ozempic for weight management on social media.
In Switzerland, it is likely that Ozempic is also being used for weight loss. Tania Weng, deputy managing director of Diabetes Switzerland, emphasizes that there has not been widespread under-treatment of type 2 diabetes patients in recent years. She suggests that the sudden spike in Ozempic demand may stem from other factors. During autumn and winter, there was a notable shortage of Ozempic, affecting not only Switzerland but many countries worldwide, as the manufacturer Novo Nordisk limited distribution. Weng noted, “We received daily inquiries from diabetes patients struggling to obtain their medications,” forcing many to resort to less effective alternatives. The situation has improved only since the summer of this year.
In response to the rising demand, Novo Nordisk has increased its production capabilities and introduced a new product, Wegovy, which is specifically approved for obesity treatment and covered by insurance. This development eliminates the need for alternative methods to secure cost coverage for weight loss injections.
Wegovy contains the same active ingredient, semaglutide, as Ozempic, acting on the body’s hormones to regulate blood sugar and induce a sense of fullness. These medications, classified as GLP-1 receptor agonists, mark a significant advancement in obesity treatment. Philipp Gerber, clinical director of the Obesity Center at the University Hospital Zurich, states, “Such medications signify a new era in obesity management.” Previously, effective treatment options were limited to surgical procedures. “Now, we have relatively safe medications with excellent efficacy,” he adds.
The adoption of Wegovy is just beginning, with clinics currently overwhelmed by patient demand. Gerber mentions, “We have long waiting lists.” As of late September, data from health insurers indicated that 11,600 patients in Switzerland were on Wegovy therapy.
This figure is only a fraction of the potential candidates, as approximately 43 percent of the Swiss population, or 3.1 million adults, are classified as obese or overweight. Gerber estimates that several hundred thousand individuals could qualify for Wegovy treatment based on approval guidelines, although each case must be evaluated by a physician.
Wegovy is poised to become the highest-grossing medication in Switzerland within a few years, with annual treatment costs of 2,150 Swiss francs—55 percent more than Ozempic. Following its approval, Ozempic sales soared from zero to 25 million Swiss francs within the first six months.
In contrast, the sales of Ozempic covered by insurance have decreased by over a third since Wegovy’s launch, further indicating the drug’s prior usage for weight loss.
To manage costs associated with GLP-1 medications, the BAG has implemented certain conditions. The insurance coverage for Wegovy is limited to severely obese patients, prescriptions must be issued by specialized clinics, and the treatment duration is capped at three years per patient. The BAG also clarifies that Wegovy’s inclusion in the specialty list is temporary, allowing for close price monitoring.
Whether these measures will mitigate the demand for Wegovy and the associated cost increases remains uncertain. Gerber expresses concern about the three-year limit on cost coverage, stating, “From a medical standpoint, this is questionable; studies indicate that patients tend to regain weight after discontinuing the medication.” He hopes for regulatory adjustments. For diabetes patients, however, the coverage for GLP-1 receptor agonists remains unrestricted.
Health insurers are advocating for price reductions as quantities dispensed rise. Elmiger from Helsana warns, “GLP-1 receptor agonists are anticipated to become a major financial burden for insurers,” and calls for sales-dependent discounts. Currently, parliament is considering legislation that ties patented medication prices to dispensing volumes.
Despite the potential for increased medication costs due to Wegovy’s popularity, health expenditures could ultimately decrease. Gerber points out that GLP-1 therapies not only promote weight loss but also alleviate obesity-related conditions such as diabetes, fatty liver disease, cardiovascular issues, and osteoarthritis. He believes that as these medications gain traction, the expenses related to secondary diseases may also decline. This is significant, as overweight individuals incur annual costs between 3.5 to 5 billion Swiss francs, according to research.
The BAG shares hopes for savings through the introduction of these new medications. However, reliable data is still lacking. The “Wegovy Journey” in Switzerland is just beginning, and the healthcare system navigates this evolving landscape with uncertainty.