Is There an Opportunity for Reimbursement of Anti-Obesity Drugs in Central and Eastern Europe?

OBJECTIVES: The escalating prevalence of obesity in Central and Eastern Europe (CEE) represents a significant public health challenge, with over 200 associated comorbidities. New weight-loss medications, glucagon-like peptide-1 (GLP-1) analogues like liraglutide and semaglutide, and tirzepatide, are considered breakthrough anti-obesity therapies. However, high prevalence of obesity, extensive patient demand and the cost of these medications pose substantial financial burdens on public healthcare systems. This research investigates the potential for reimbursement of these anti-obesity drugs in selected CEE countries.

METHODS: We reviewed health technology assessment (HTA) reports and access conditions for GLP-1 analogues and tirzepatide in Poland, Czechia, Slovakia, and Estonia. As these drugs were first approved for type 2 diabetes (DM2), respective HTA recommendations were analyzed, too. The comparisons were made with access conditions in Western European (WE) countries (Germany, France, Spain, Italy, UK).

RESULTS: In the selected CEE countries, GLP-1 analogues and tirzepatide are not reimbursed for obesity. There are legislations restricting (Poland) or excluding (Slovakia) reimbursement of anti-obesity drugs. Semaglutide is reimbursed for DM2 across all countries and liraglutide in Czechia and Estonia, both with conditions. Prescription limitations are implemented in Czechia and Slovakia. In Poland semaglutide is reimbursed only in obese patients with DM2. In Estonia, obesity increases reimbursement rate in patients with DM2. In WE, access to anti-obesity drugs is limited to UK where GLP-1s are reimbursed with conditions (population, prescribing limitations, duration of treatment). In France, semaglutide was available under an early access program which was withdrawn. In Germany, lifestyle drugs (including anti-obesity drugs) are excluded from reimbursement.

CONCLUSIONS: Increasing awareness of the health and economic consequences of obesity-related comorbidities is pressing policymakers to find viable solutions. Effective implementation of reimbursement policies in CEE will require stringent patient selection criteria, treatment conditions and integration within comprehensive lifestyle modification programs.