Chinese doctors call for insurance coverage for weight-loss drugs

BEIJING - Some doctors in China want national insurance coverage for weight-loss drugs to tackle endemic obesity, medical professionals said.

Obesity is China’s sixth leading risk factor in disability and death, yet long-term weight-loss drugs that doctors have said could help reduce its prevalence can cost half a patient’s salary.

“Rising obesity rates combined with the high cost of treatment drugs are straining the healthcare system, prompting physicians to address access gaps,” said Professor Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations.

Unhealthy meals and stressful or less physically demanding jobs are set to push the rate of overweight or obese people to over 65 per cent by 2030, in the world’s second-most populous country with 1.4 billion people.

The government introduced its first set of guidelines in 2024 to standardise the diagnosis and treatment of obesity.

Yet, it does not plan to include weight-loss drugs in the national medical insurance scheme, instead directing funds elsewhere.

However, calls to subsidise weight-loss drugs in a field where professionals are usually reluctant to be associated with public campaigns highlight the risk that weight-related problems pose to the healthcare system.

“If you are able to put them in medical insurance, you can help patients, help considerably more impoverished patients to persevere,” said Dr Shao Xinyu, an endocrinologist in the eastern biotech hub of Suzhou.

“There must be many doctors with the same opinion, more or less,” said Dr Shao, who supports coverage for patients with a body mass index (BMI) above 32.5 and no other health issues, or lower for people who have serious health problems.

Obesity is associated with increased risk of health problems such as cancer and heart disease.

In China, a BMI – an estimate of fat based on the ratio of weight to height – from 24 is regarded as overweight, and from 28, obese.

Cost makes patients hesitate to use weight-loss drugs for an extended period, said endocrinologist Jin Jie in the south-eastern coastal county of Ninghai. Dr Jin said she bought medicine for a patient who could not find work due to obesity.

A year’s supply of a weight management drug from one drugmaker can cost up to 35,040 yuan (S$6,225), a Reuters calculation showed.

That is equivalent to about 50 per cent of the average annual wage of urban private-sector employees in 2024.

In particular, a type of weight-loss drug known as GLP-1 should be subsidised to benefit obese patients with serious comorbidities, or multiple health issues, said cardiologist Zhang Yuqing in Beijing.

The National Healthcare Security Administration did not respond to a request for comment.

Price pressure could make up for lack of subsidy

China is home to several producers of weight-loss drugs, such as Innovent Biologics, Huadong Medicine and Shanghai Benemae Pharmaceutical. However, the market share of the different drugs is opaque.

“The (China) market is not growing as much as we had anticipated... It is predominantly because we have never launched a previous version of obesity drugs in that market,” Novo Nordisk CEO Mike Doustdar said at a briefing.

Mr Doustdar also cited the challenge of competitors. “If you have a mega brand, then it is a very different picture,” he said.

The expiration in 2026 of a key patent for Novo’s blockbuster weight-loss drug Wegovy could increase competition as drugmakers including CSPC Pharmaceutical and Hangzhou Jiuyuan Genetic Biopharmaceutical develop their own versions of the treatment.

In the absence of subsidies, competition from such generics could help make weight-loss drugs more affordable. “Single-target GLP-1 without clear differentiation could be subject to the pricing pressure from the generics,” Goldman Sachs analysts wrote in a report. REUTERS