One of the world’s most sought-after drugs has officially become a vital medication. The World Health Organization has just added semaglutide—the active ingredient in Ozempic and Wegovy—to its list of essential medicines.
The WHO’s Model Lists of Essential Medicines is designed to improve affordability and access for the world’s most impactful drugs. Semaglutide and other GLP-1 drugs are among 20 new additions to the list, and it’s clear why. GLP-1s have completely reshaped how clinicians treat type 2 diabetes and obesity, with more possible uses being explored or on the horizon—but the most effective versions are expensive, scarce, and often aren’t covered by insurance.
“The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact,” said Yukiko Nakatani, assistant director-general for health systems, access and data, in a statement.
What are ‘essential’ medicines?
The WHO first released its list of essential medicines in 1977. With the new additions, there are some 523 essential medicines for adults and 374 for children.
The list was initially aimed at identifying the drugs most needed in developing countries, but it has since become a global guide, highlighting the medicines most likely to broadly improve public health worldwide. More than 150 countries use the WHO’s recommendations to help decide which medications to prioritize purchasing, to cover through public insurance, or to otherwise make more available and affordable.
That’s why it’s so notable that semaglutide and two other GLP-1 drugs (dulaglutide and liraglutide) have been added to the essential medicines list this year. These drugs mimic GLP-1, a hormone that regulates the body’s hunger cues and our metabolism, among other things. Tirzepatide—which combines GLP-1 with another hunger-related hormone, GIP-1—has also been added to the WHO’s list.
Why GLP-1s are essential but often out of reach
GLP-1 drugs, and particularly semaglutide and tirzepatide, are game-changers for diabetes and obesity treatment. The drugs reliably help people with type 2 diabetes control their blood sugar, and they’re much more effective at helping people lose weight than through diet and exercise alone. They’re also safe and generally tolerable, although gastrointestinal side effects like nausea and diarrhea are common.
Both diabetes and obesity can lower a person’s lifespan and raise their risk of many other chronic diseases, including cancer. And it seems as though these drugs may already be turning the tide against obesity in particular: 2023 was the first year in a decade that the adult obesity rate in the U.S. dropped.
As effective as GLP-1 drugs are, they’re also largely out of reach for many of the people most eligible to take them. Even with recent price drops, the latest versions still cost hundreds of dollars a month to buy out of pocket, and in the U.S., public and private insurers will often not cover them.
The WHO’s move to add them to its essential medications list is a direct play to bring the cost of GLP-1s down. Public health officials could take actions like prioritizing access to the people most likely to benefit from GLP-1s, encouraging the development of generic versions, and making them more easily available through primary care.
“Achieving equitable access to essential medicines requires a coherent health system response backed by strong political will, multisectoral cooperation, and people-centered programs that leave no one behind,” said Deusdedit Mubangizi, the WHO’s director of policy and standards for medicines and health products, in a statement.
Canada is expected to become one of the first countries to approve generic versions of semaglutide as early as next year. The U.S., however, will likely wait until 2031 at the earliest.
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