Wegovy and Saxenda are prescription-only GLP-1 receptor agonist injections licensed for weight management in adults with obesity or overweight with comorbidities. Wegovy and Saxenda cost varies significantly depending on whether you access them via the NHS or privately. NHS availability is strictly limited by NICE criteria and regional commissioning, whilst private prescriptions typically range from £150 to £299 monthly, representing a substantial long-term financial commitment. Understanding eligibility, comparative effectiveness, and total treatment costs is essential for informed decision-making about these medications.

Understanding Wegovy and Saxenda: What They Are and How They Work

Wegovy (semaglutide 2.4mg) and Saxenda (liraglutide 3mg) are both injectable medications licensed for weight management in adults with obesity or overweight with weight-related health conditions. Both belong to a class of medicines called GLP-1 receptor agonists, which were originally developed for type 2 diabetes management but have demonstrated significant efficacy in promoting weight loss.

These medications work by mimicking the action of glucagon-like peptide-1 (GLP-1), a naturally occurring hormone that regulates appetite and food intake. The mechanism of action involves several pathways: they slow gastric emptying (making you feel fuller for longer), reduce appetite by acting on brain centres that control hunger, and improve insulin secretion whilst reducing glucagon release in a glucose-dependent manner. This multi-faceted approach helps patients achieve meaningful weight reduction when combined with lifestyle modifications.

Wegovy is administered once weekly via subcutaneous injection, whilst Saxenda requires daily injections. Semaglutide (Wegovy) has a longer half-life than liraglutide (Saxenda), which accounts for the difference in dosing frequency. Clinical trials have shown that Wegovy typically produces greater average weight loss—approximately 15% of body weight over 68 weeks—compared to Saxenda's average of 8-10% over 56 weeks.

Both medications are intended as adjuncts to a reduced-calorie diet and increased physical activity, not standalone solutions. Common adverse effects include nausea, diarrhoea, vomiting, constipation, and abdominal pain, which are usually mild to moderate and tend to diminish over time as the body adjusts to treatment. More serious but less common risks include acute pancreatitis and gallbladder disease. Patients should be alert to severe abdominal pain and seek immediate medical attention if this occurs. These medicines are not suitable during pregnancy or breastfeeding.

Patients should report any suspected side effects via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk). These are prescription-only medicines requiring medical supervision throughout the treatment course.

NHS Availability and Prescription Criteria for Weight Loss Injections

Access to Wegovy and Saxenda through the NHS is strictly limited and governed by specific eligibility criteria established by NICE (National Institute for Health and Care Excellence). As of current guidance, these medications are not routinely available across all NHS trusts, and availability varies significantly by region due to commissioning decisions and budget constraints.

NICE guidance (TA875) recommends Wegovy for weight management in adults with:

• A body mass index (BMI) of 35 kg/m² or more with at least one weight-related comorbidity, or

• A BMI of 30-34.9 kg/m² with at least one weight-related comorbidity (such as hypertension, type 2 diabetes, dyslipidaemia, obstructive sleep apnoea, or cardiovascular disease)

• As part of a specialist weight management service (Tier 3 or 4)

For Saxenda, NICE guidance (TA664) recommends it under more restrictive criteria, including a BMI of at least 35 kg/m² (or 32.5 kg/m² for people from certain minority ethnic groups) and specific comorbidities, after non-surgical interventions have been unsuccessful.

Lower BMI thresholds apply for people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean backgrounds, who may be eligible at lower BMI levels due to higher risk at lower weight.

Important prescribing conditions include that treatment should only continue beyond the initial period if patients achieve at least 5% weight loss after 12 weeks on the maintenance dose (for both medications). Treatment should be stopped if this target is not met. NHS-funded treatment is typically limited to a maximum of 2 years. Additionally, patients must be enrolled in a comprehensive weight management programme that includes dietary advice, physical activity support, and behavioural interventions.

In practice, NHS waiting lists for specialist weight management services can be extensive, with waiting times varying considerably by location. Many patients who meet clinical criteria find that their local Integrated Care Board (ICB) does not commission these treatments, effectively limiting NHS access. Patients should discuss eligibility with their GP, who can provide referral to specialist services where available and explain local commissioning arrangements.

Private Prescription Costs: Wegovy vs Saxenda in the UK

For patients unable to access these medications through the NHS or preferring not to wait, private prescription is an alternative option, though costs are substantial and represent a significant financial commitment.

Wegovy costs in the UK private market typically range from £199 to £299 per month, depending on the pharmacy, prescribing service, and dosage phase. The medication requires a gradual dose escalation over 16-20 weeks, starting at 0.25mg weekly and increasing to the maintenance dose of 2.4mg weekly. Some private providers offer package deals or subscription models that may reduce per-month costs slightly, with annual expenditure ranging from approximately £2,400 to £3,600.

Saxenda costs are generally comparable or slightly lower, ranging from £150 to £250 per month. As a daily injection, patients require multiple pens per month (typically 3-5 pens depending on the dose), with annual costs between £1,800 and £3,000. The dose escalation for Saxenda occurs over 4-5 weeks, reaching a maintenance dose of 3mg daily.

These indicative prices may include some or all of the following, but this varies significantly between providers:

• The medication itself

• Initial medical consultation and assessment

• Prescription issuance

• Delivery to your home

• Some level of ongoing clinical support

Additional costs to consider include:

• Follow-up consultations (£30-£80 per appointment)

• Blood tests if required (£50-£150)

• Sharps disposal containers

• Potential costs if switching between medications

It's crucial to note that prices fluctuate based on supply chain factors, manufacturer pricing changes, and market demand. During periods of shortage (which have affected both medications), prices may increase significantly. Patients should obtain current pricing from multiple registered UK pharmacies and ensure any provider is regulated by the General Pharmaceutical Council (GPhC) and Care Quality Commission (CQC) where applicable. You can verify registration via the GPhC and CQC online registers.

Factors That Affect the Cost of Wegovy and Saxenda Treatment

Several variables influence the overall cost of treatment with these weight loss medications, and understanding these factors can help patients make informed financial decisions.

Prescribing route is perhaps the most significant factor. NHS prescriptions, where available, incur only standard prescription charges (currently £9.90 per item in England, free in Scotland, Wales, and Northern Ireland, or covered by prepayment certificates). Private prescriptions carry the full commercial cost of the medication plus service fees. Some patients may be eligible for NHS prescription but choose private routes to avoid waiting times.

Treatment duration substantially impacts total expenditure. NICE recommends reviewing treatment continuation at regular intervals, with NHS-funded treatment typically limited to a maximum of 2 years within specialist services. Many patients require 12-24 months of treatment to achieve and maintain their weight loss goals. Some individuals may benefit from longer-term treatment, as weight regain commonly occurs after discontinuation. This transforms what might appear as a manageable monthly cost into a multi-year financial commitment potentially exceeding £10,000.

Dose requirements vary between individuals. Whilst most patients reach standard maintenance doses, some may respond adequately to lower doses, potentially reducing costs. Conversely, some patients may require the maximum licensed dose throughout treatment. The dose escalation phase is generally fixed, but maintenance dose flexibility exists.

Provider choice creates price variation. Online prescribing services, high-street pharmacies, private GP practices, and specialist weight management clinics all offer different pricing structures. Bundled packages that include consultations, monitoring, and nutritional support may appear more expensive initially but could offer better value than medication-only services. Patients should compare total package costs rather than medication prices alone.

Supply chain issues have periodically affected both medications, with shortages leading to temporary price increases or complete unavailability. Manufacturer supply problems, increased global demand, and distribution challenges can all impact costs and access. NHS England has issued advisories on GLP-1 RA supply constraints, which can affect both NHS and private availability. Patients established on treatment may face interruptions requiring switches to alternative medications.

Is There a More Affordable Option? Comparing Value and Effectiveness

When considering the substantial costs of Wegovy and Saxenda, patients naturally question whether more affordable alternatives exist that deliver comparable results.

Generic or biosimilar options are not yet available for these medications in the UK, as patent protections remain in place. Semaglutide is available as Ozempic for type 2 diabetes (at lower doses than Wegovy), but prescribing it off-label for weight loss is not recommended by NHS England due to supply constraints. Using diabetes-licensed medications for weight management without appropriate indication raises regulatory and safety concerns. Most private medical insurance (PMI) policies do not cover weight-loss medicines.

Orlistat (Xenical/Alli) represents the only other medication licensed for weight management available at significantly lower cost—approximately £20-£50 monthly for generic versions. However, its mechanism (reducing fat absorption) differs entirely from GLP-1 agonists, and efficacy is considerably lower (average 3-5% weight loss). Orlistat also causes distinctive gastrointestinal side effects that many patients find intolerable. It may suit patients with modest weight loss goals or limited budgets, but expectations should be appropriately managed.

Comparing Wegovy and Saxenda directly: whilst Wegovy costs slightly more monthly, its superior efficacy (approximately 15% vs 8-10% average weight loss) and once-weekly convenience may represent better value for many patients. The cost per kilogram lost may be more favourable with Wegovy despite higher absolute costs, though individual responses vary significantly. Some patients may respond better to Saxenda or tolerate it more easily.

Non-pharmaceutical approaches deserve consideration. Comprehensive lifestyle modification programmes, though requiring significant commitment, incur lower financial costs. NHS-funded programmes like the NHS Digital Weight Management Programme are free for eligible patients. Private nutritionists, personal trainers, and behavioural therapists involve costs (£40-£100+ per session) but may be more affordable long-term than medication.

Value assessment should consider:

• Total weight loss achieved

• Improvement in comorbidities (potentially reducing other medication costs)

• Quality of life benefits

• Sustainability of weight loss

• Individual tolerability and adherence

Patients should discuss all options with their healthcare provider, considering both clinical suitability and financial sustainability. When to seek medical advice: contact your GP if you're struggling with weight management, experiencing weight-related health complications, or considering weight loss medications. They can assess eligibility for NHS services, discuss appropriate treatment options, and provide referrals to specialist services where indicated.

Frequently Asked Questions