Fighting obesity, on free drugs Italy now studies the British model

The landing of the new anti-obesity drugs on the National Health Service - for free or against payment of a co-payment - is approaching. The arrival of these innovative therapies in Italy is being driven by the approval of the law that recognises obesity as a real 'progressive and relapsing' disease by the summer. Obesity sufferers will have the right to receive free treatment that will be provided for by the essential levels of care, i.e., those services that the National Health Service must guarantee to all citizens, uniformly throughout the country.

The Ddl should receive the green light from the Chamber of Deputies on 6 May and immediately after that from the Senate, and as soon as this manifesto-law composed of just a few articles enters into force, it will open the door to the treatment of obesity in our country as well, and to the possible reimbursability of the drugs that are increasingly appearing on the market. That is why a delegation from the Italian Medicines Agency - led by AIFA president Robert Nisticò and board member Emanuele Monti, also representing Lombardy - flew to England in recent days to forge closer ties of collaboration with the Medicines Regulatory Agency across the Channel on various dossiers, but also to study the path already taken by London on the war on obesity: In particular, Aifa, which is also attended by a number of Italian and European patient associations in the sector, is trying to understand how and whether to replicate the English model here too, not least because the National health service is very similar in its operation to our SSN.

At the moment, in fact, the British Health Service has recommended through Nice (the National Institute for health and care excellence) the reimbursability of a drug for obesity in adult patients who meet certain specific requirements: very advanced obesity (second degree obesity with a body mass index - BMI - greater than or equal to 35 kg/m²) and at least one other important weight-related pathology (type 2 diabetes, hypertension, cardiovascular disorders). These requirements restrict the potential pool of beneficiaries. Its prescription is then envisaged in association with a low-calorie diet and increased physical activity, while its reimbursability is conditioned by the achievement, within 6 months, of a weight loss equal to or greater than at least 5 per cent. Otherwise, the continuation of therapy is evaluated on the basis of the benefit-risk balance for the patient. The mission was also an opportunity to delve into a truly innovative study also on the subject of obesity, which is a public-private partnership in the Manchester district that has been going on for five years and will first of all analyse the clinical impact of innovative drugs on obesity, diabetes and related comorbidities with real patient data (so-called 'real world evidence'). The innovative part will concern the fact that the effects on the possible reduction of direct and indirect public health expenditure in the medium to long term will also be examined: under the lens will end up not only the direct effects on health but also the consequences both in social life (inactivity, limitations) and at work by measuring them e.g. on the basis of absences from work or disabilities. This study could be replicated in Italy, with Lombardy leading the way.