ORAL WEGOVY PILL ARRIVES IN SCOTLAND


Pharmacists consider impact


Approval has now been given for the UK’s first weight loss pill. The once daily semaglutide tablet is authorised to treat adults in the UK who have a BMI of 30 and above (obese) or a BMI between 27 and 30 (overweight) and at least one weight-related comorbidity.


Richard Grahame, owner of Callendar Pharmacy Group, said he was expecting to see significant demand for the medication, with particular interest from patients who may benefit from weight loss medication but who had been reluctant to start injectable treatments.


“Injectable GLP-1 treatments have already transformed the obesity treatment landscape and generated unprecedented levels of patient interest. An oral option removes one of the major barriers to treatment for many patients who are uncomfortable with self-injection,” he said.


“The convenience of a daily tablet is likely to make treatment more accessible and acceptable to a wider patient population, potentially increasing demand beyond anything we’ve seen with injectable therapies.”


Managing Patient Expectations


Richard said as a pharmacy group already experienced in supporting patients using GLP-1 medicines, their focus was on ensuring their teams were fully trained on patient selection, counselling, side effect management and ongoing monitoring.


“Operationally, the biggest challenge is likely to be managing demand and patient expectations, particularly if initial supply is constrained or if patients view the tablet as a simple alternative to a lifestyle change. Weight management remains a long-term clinical intervention rather than a quick fix and pharmacies will play an important role in reinforcing that message.”


He is expecting questions from patients around the effectiveness of the tablet compared with injectable treatments, expected weight loss, side effects, duration of treatment and whether the medication will be available through NHS prescribing pathways.


“Community pharmacies are ideally placed to support patients throughout their treatment journey. Pharmacists can provide education on how to take the medication correctly, manage side effects, monitor progress and identify when treatment may no longer be appropriate


14 scotpharm.com


or effective. Importantly, pharmacies can help ensure that treatment is delivered safely and as part of a broader approach that includes nutrition, exercise and behavioural change,” said Richard.


He believes approval of the weight loss pill provides community pharmacies with the opportunity to cement their position as accessible clinical providers delivering evidence-based weight management services.


“Pharmacists have demonstrated their ability to manage long-term conditions and support patients with complex medicines and obesity management is a natural extension of that role. The biggest challenge will be ensuring that funding and service models evolve alongside patient demand. Scottish community pharmacies are already under considerable workload pressures and if pharmacies are expected to provide clinical oversight and ongoing monitoring for these therapies, appropriate remuneration and investment in the sector will be essential.”


Dangers Posed By Online


At Romanes Pharmacy in the Scottish Borders, owner George Romanes agreed that demand for the newly approved medication is likely to be high from the outset. He said the treatment gave pharmacies the opportunity to help with wellness rather than illness.


“As a small company we have installed a Meditech robot and gone to a hub and spoke model so we now have some capacity for new services and existing services like Pharmacy First Plus. We are busy reading up and thinking about the demand and appointments,” he said.


He said he was concerned about patients using the internet to access the treatment.


“Some patients are keen to titrate up too quickly, so advice from a private pharmacy setting is so important. However some will still use the internet as it is almost too easy.”


Evidence-Based Advice


Sarah Macfarlane is the owner and clinical director of both Macfarlanes Pharmacy in Stirling, and The Tarvit Clinic in Cupar, Fife. She said they were not doing anything differently operationally and always tried to offer patients the opportunity to speak to a pharmacist. She said demand for the Wegovy pill was there even prior to its release.


“We have been inundated with questions since the public was made aware it was coming to UK pharmacies imminently. The online providers were advertising before we even had stock,” she said.


Sarah said most patients' first questions had been around the price of the tablet compared to the injections.


“This has been heavily marketed as a cheaper alternative to injections. This has transpired not to be so. It is cheaper than Mounjaro but not cheaper than Wegovy injections.


“Many people, who were already patients of ours, have asked if I think the tablets will be as good as injections. It is the responsibility of the prescriber, whoever that may be, to ensure the medication they are prescribing will be safe and effective for the patient. It is not the responsibility of community pharmacies in a general sense,” she said.


Sarah said that she didn’t view the approval of the medication as an opportunity for community pharmacy.


“I have a responsibility to my patients to ensure they are provided with evidence-based advice and information. This allows them to make an educated, informed decision regarding their health and wellbeing. And those choices will be different for different patients, depending on their circumstances.


“The addition of Wegovy oral tablets to the weight loss sphere is just an example of where research and medications move forward with time. I keep myself up to date with progress to ensure my practice is in line with the current evidence. As all clinicians should.


“I believe that the big power-house online players are capitalising on what they see as an ‘opportunity’. An opportunity to sell something. I’m a clinician. I help people make informed decisions, I’m not in the business of selling,” she said.


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