Baseline Characteristics of Patients Approved for Reimbursement of Liraglutide (Saxenda®) for Weight Management Under a Managed Access Protocol in Ireland

OBJECTIVES: To investigate the baseline characteristics of patients approved for the reimbursement of liraglutide (Saxenda®) for weight management under a Managed Access Protocol (MAP) in Ireland in 2023. The MAP outlines that initial reimbursement will be approved for adult patients with body mass index (BMI) of greater than or equal to 35 kg/m² with prediabetes and high-risk for cardiovascular disease.

METHODS: Data extracted from applications submitted as individual patient reimbursement initiation requests on the Health Service Executive-Primary Care Reimbursement Service (HSE-PRCS) online application system were analysed in R-Studio. Applications submitted between 1 January 2023 and 31 December 2023 were eligible for inclusion.

RESULTS: During the study period, 4,139 individual patients were approved for reimbursement of liraglutide for weight management, based on an application submitted through the HSE-PCRS online application system. Almost 70% of approved patients were female (n=2,888) with a mean age of 54.3 years. Patients approved for reimbursement had a mean weight of 121.1 kg and median BMI of 42.1 kg/m². Approved patients had a mean fasting plasma glucose of 6.95 mmol/L, a mean HbA1c of 41.52 mmol/mol while 47.4% (n=1,961) of patients were treated with lipid lowering therapy at baseline, with more males on such medication at baseline (55.3% of males versus 41.15% of females). Approved patients had a mean fasting total cholesterol level of 5.45 mmol/L with 63.1% (n=2,611) treated with anti-hypertensive therapy at baseline, with more males on such medication at baseline (70.31% of males versus 60.15% of females).

CONCLUSIONS: This study demonstrates that during the first year of the MAP, initial reimbursement of liraglutide was restricted to a subpopulation where cost-effectiveness was considered plausible. The MAP and online application system require a second application to be approved for continued reimbursement, which is conditional on weight loss, thus supporting patient access to liraglutide while promoting cost-effective prescribing.