Continuing a string of National Institute of Health and Care Excellence (NICE) rejections, Novo Nordisk’s weight management drug Saxenda (liraglutide) is next to take a hit from the organisation.

NICE has issued a draft guidance on the treatment, in which it is not recommended, within its marketing authorisation, for managing overweight and obesity in adults alongside a reduced-calorie diet and increased physical activity.

The decision was allegedly made as clinical trial evidence showed that Saxenda’s long-term effectiveness, particularly on reducing the risk of cardiovascular disease, is unknown despite the drug with lifestyle measures being more effective for weight loss. It was also shown to delay the development of type II diabetes more than lifestyle measures alone, but NICE cites “uncertainty in the clinical evidence, even in this high-risk subgroup”, as well as “highly uncertain” cost-effectiveness.

Obesity is very common in England, affecting about 26% of the adult population. Current management for overweight and obesity is either: lifestyle measures alone; lifestyle measures with orlistat (sold as Alli by GSK); or bariatric surgery.

Recently, NICE also decided not to recommended Bayer’s Viktravi (larotrectinib), MSD’s Keytruda (pembrolizumab) for unresectable recurrent head and neck squamous cell carcinoma (HNSCC), citing no “potential to be cost-effective” and uncertainty in evidence, respectively.

On top of that, the organisation also refused Janssen’s Stelara (ustekinumab), again for cost-effectiveness reasons, AZ’ Tagrisso (osimertinib) for “insufficient evidence of efficacy” and Akcea’s Waylivra (volanesorsen) due to “concerns around the clinical evidence and high cost”.