Wegovy (semaglutide 2.4 mg) is a once-weekly injectable medication for weight management, available through the NHS for eligible patients. Understanding Wegovy NHS cost and access pathways is crucial for those considering this treatment. Whilst private prescriptions can exceed £200–£300 monthly, NHS provision means patients pay only standard prescription charges—currently £9.90 per item in England, or free in Scotland, Wales, and Northern Ireland. Eligibility is determined by NICE guidance, requiring specialist weight management service referral rather than routine GP prescription. This article explains NHS eligibility criteria, access routes, prescription costs, and how Wegovy compares to private provision.

What Is Wegovy and How Does It Work?

Wegovy (semaglutide 2.4 mg) is a once-weekly injectable medication licensed for weight management in adults with obesity or those who are overweight with weight-related health conditions. Manufactured by Novo Nordisk, it belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed for type 2 diabetes management.

The medication works through several complementary mechanisms. Semaglutide mimics the action of GLP-1, a naturally occurring hormone that regulates appetite and food intake. It acts on receptors in the brain's appetite centres, particularly the hypothalamus, to reduce hunger and increase feelings of fullness after eating. Additionally, it slows gastric emptying, meaning food remains in the stomach longer, which contributes to prolonged satiety between meals.

Clinical trials have demonstrated that Wegovy, when combined with a reduced-calorie diet and increased physical activity, can lead to significant weight loss. The STEP (Semaglutide Treatment Effect in People with obesity) trial programme showed average weight reductions of 10–15% of initial body weight over 68 weeks. Beyond weight loss, patients often experience improvements in cardiovascular risk factors, including blood pressure, cholesterol levels, and glycaemic control.

Wegovy is administered via a pre-filled injection pen, with doses typically increased every 4 weeks to reach the maintenance dose of 2.4 mg (slower titration may be needed if side effects occur). Common adverse effects include nausea, diarrhoea, vomiting, constipation, and abdominal pain, which typically diminish as the body adjusts to treatment.

Important safety considerations include risks of pancreatitis and gallbladder disease, potential dehydration from gastrointestinal side effects, and worsening of diabetic retinopathy in people with diabetes. Wegovy should not be used during pregnancy or breastfeeding. Patients should seek urgent medical attention for severe, persistent abdominal pain (especially if radiating to the back) as this may indicate pancreatitis.

Patients should report any suspected side effects via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk or the Yellow Card app). This is a long-term treatment requiring ongoing commitment to lifestyle modifications for optimal results.

How to Access Wegovy Through the NHS

Accessing Wegovy through the NHS follows a structured pathway aligned with NICE guidance (TA875), published in March 2023. The medication is available through specialist weight management services (Tier 3/4) rather than routine GP prescription, reflecting the need for comprehensive support alongside pharmacological intervention.

To begin the process, patients should first consult their GP to discuss weight management options and determine eligibility. The GP will assess body mass index (BMI), relevant comorbidities, and previous weight loss attempts. If appropriate, they will refer the patient to an NHS specialist weight management service. These services are typically delivered through hospital-based clinics or community programmes with multidisciplinary teams including dietitians, specialist nurses, and physicians.

The specialist service will conduct a thorough assessment, including:

• Detailed medical history and examination

• Baseline measurements (weight, BMI, waist circumference, blood pressure)

• Blood tests to exclude secondary causes of obesity and assess metabolic health

• Psychological assessment to identify barriers to weight loss

• Discussion of realistic goals and treatment expectations

Patients must demonstrate commitment to lifestyle modification, including dietary changes and increased physical activity. The service will provide structured support through regular appointments, typically monthly initially, to monitor progress, manage side effects, and reinforce behavioural changes.

It is important to note that while NICE Technology Appraisals must be funded by the NHS within 90 days of publication, waiting times may vary due to service capacity and local implementation. Some areas have established pathways with relatively short waiting times, whilst others face significant delays due to limited specialist service capacity. Patients should enquire about local waiting times when discussing referral options with their GP.

Note that lower BMI thresholds (typically 2.5 kg/m² lower) apply for people from some ethnic groups, including South Asian, Chinese, Black African and African-Caribbean backgrounds, reflecting their higher health risks at lower BMI levels.

Private Prescription Costs vs NHS Provision

The cost difference between NHS and private provision of Wegovy is substantial, making access route a significant consideration for many patients. Understanding these financial implications helps individuals make informed decisions about their weight management journey.

Private prescription costs for Wegovy are considerable. As of early 2024, the medication itself typically costs £200–£300 per month when obtained through private prescription, translating to approximately £2,400–£3,600 annually. Prices may vary by provider, dose, and current supply availability. This covers only the medication; additional costs include private consultation fees (£100–£250 for initial assessment, £50–£150 for follow-up appointments), baseline investigations, and ongoing monitoring. Over a two-year treatment course, total private costs can easily exceed £5,000–£7,000.

Several private providers offer Wegovy through online services or clinic-based consultations. Whilst convenient, patients should ensure they choose providers regulated by the Care Quality Commission (CQC) in England, Healthcare Improvement Scotland (HIS), or Healthcare Inspectorate Wales (HIW), and use General Pharmaceutical Council (GPhC) registered pharmacies. Some providers offer subscription models or payment plans to spread costs, but the cumulative expense remains significant.

Patients should be aware that ongoing GLP-1 supply constraints may affect availability and pricing; it's advisable to check current supply status before committing to private treatment.

In contrast, NHS provision means patients pay only standard prescription charges where applicable. In England, this is currently £9.90 per prescription item (or free for those with exemptions). Scottish, Welsh, and Northern Irish residents receive free NHS prescriptions. Prescription intervals may vary according to local policy. Beyond medication costs, all consultations, monitoring, and support services are provided without additional charge.

Important consideration: Most standard health insurance policies in the UK do not cover Wegovy or associated consultations, as obesity treatment is often excluded. Patients considering private routes should verify coverage with their insurer beforehand.

Wegovy NHS Cost and Prescription Eligibility

NHS prescription eligibility for Wegovy is determined by specific clinical criteria established in NICE Technology Appraisal 875. Understanding these criteria is essential for patients considering this treatment option.

NHS eligibility criteria include:

• Adults with at least one weight-related comorbidity and a BMI ≥35 kg/m² (lower BMI thresholds apply for some ethnic groups, typically 2.5 kg/m² lower)

• Adults with a BMI of 30–34.9 kg/m² may be considered only if they meet criteria for referral to specialist weight management services

• Evidence of previous weight management attempts through diet and exercise

• Commitment to a specialist weight management programme with ongoing support

The medication must be prescribed within specialist weight management services (Tier 3/4), not by GPs in primary care. Local services may prioritise patients based on clinical need, but this does not change the fundamental eligibility criteria.

Treatment continuation criteria are equally important. According to the UK product licence (SmPC), Wegovy should be discontinued if patients do not achieve at least 5% weight loss after 6 months of treatment at the maintenance dose. This ensures NHS resources are directed toward those deriving meaningful benefit.

For NHS patients, the prescription charge applies as outlined previously (£9.90 per item in England, free in Scotland, Wales and Northern Ireland). Those with valid exemption certificates—including individuals receiving certain benefits, those with specified medical conditions, or aged over 60—pay nothing.

Duration of treatment under NHS funding is limited to a maximum of 2 years, as specified in NICE TA875. After this period, patients will need to discuss alternative weight management strategies with their healthcare team.

If patients do not meet criteria for Wegovy, alternative NHS weight management options may include other medications (such as orlistat), psychological interventions, or consideration for bariatric surgery in appropriate cases according to NICE guidelines.

Frequently Asked Questions