Thousands of overweight people in Scotland have been given 'new hope' after the weight loss injection Wegovy (semaglutide) was approved for wider use on the NHS. The decision follows a landmark trial showing the medication cuts the risk of serious heart problems, including heart attacks and strokes, by 20%.
Wider access to Wegovy
On Monday, the Scottish Medicines Consortium (SMC) recommended Wegovy as the first GLP-1 RA to reduce the risk of major adverse cardiovascular events (MACE) in adults with established cardiovascular disease and a body mass index (BMI) of 27 or higher. Previously, the drug was available only to a small number of patients under strict rules, forcing most to buy it privately. Now, thousands more will be eligible on the NHS.
Impact on cardiovascular health
Novo Nordisk, the manufacturer of Wegovy, hailed the decision, noting that ischaemic heart disease remains a leading cause of death in Scotland, responsible for over 17,000 deaths annually—nearly 50 people every day—at a cost of approximately £950 million per year to NHS Scotland. The burden is disproportionately high in deprived communities, where cardiovascular disease prevalence is double that of the least deprived areas.
How Wegovy works
Wegovy is a weekly injectable medication that mimics the natural hormone GLP-1, helping to regulate appetite, reduce food intake, and promote weight loss. The SMC's decision is based on the SELECT trial, which demonstrated that semaglutide 2.4 mg, added to standard care, reduced the first occurrence of MACE by 20% compared to placebo, independent of weight loss. Over the trial period, MACE occurred in 6.5% of participants receiving semaglutide versus 8.0% receiving placebo.
Additional benefits and safety
The SELECT trial also showed statistically significant improvements in health-related quality of life. Supportive evidence from the STEP-HFpEF study indicated meaningful improvements in symptoms and physical limitations for patients with obesity-related heart failure. The safety profile was consistent with previous trials; serious adverse events were lower with semaglutide, though gastrointestinal symptoms led to more treatment discontinuations.
Dr Rob Peel, Chair of the SMC, said: 'Semaglutide will provide a useful treatment option to help reduce major cardiovascular events in patients who are overweight and have cardiovascular disease.'
Sebnem Avsar Tuna, General Manager of Novo Nordisk UK, added: 'We are delighted that the SMC has recognised the value semaglutide can bring to people in Scotland living with established cardiovascular disease and overweight or obesity. We are now working closely with NHS Boards across Scotland to ensure this treatment reaches those who need it as quickly as possible.'
Following recent recommendations by NICE in England, Wegovy is now approved for this preventative cardiovascular use across all four nations of the United Kingdom.
