Estonia considers expanding coverage for weight-management drug

The Estonian Health Insurance Fund (EHIF) is considering expanding coverage for a Type 2 diabetes drug to patients with obesity, pending a cost-benefit analysis due this fall. Currently, GLP-1 agonist drugs such as Ozempic, Wegovy and Mounjaro cost about €90–180 a month and are not covered when prescribed for weight management, leaving patients to pay the full price.

Endocrinologist Kristina Isand said that excess body weight and related complications should be treated as a chronic condition in clinical practice. "That's the shift in mindset we need — that obesity is a chronic illness, just like Type 2 diabetes," Isand said. She noted that when prescribing the medication to diabetes patients, they understand it's a lifelong treatment, and the same approach should apply to obesity.

EHIF reimbursement lead Getter Hark said the Wegovy application is under review, awaiting an updated analysis weighing costs against broader health benefits. "They'll be taking absolutely all of the drug's possible health benefits into account and comparing them with the costs," Hark explained, adding that the assessment is being updated due to changes in drug prices and data.

Hark noted potential costs vary widely depending on eligibility criteria and patient numbers. "In the previous report, the estimated annual cost ranged from €18 million to €500 million, depending on how many patients would be covered," she added.

Isand said that in addition to treating Type 2 diabetes, GLP-1 and GLP-2 agonist drugs may improve metabolic and cardiovascular health and offer multi-organ benefits. "These may be some of the most significant drugs of this century, in terms of adding healthy years to one's life," she added.