The UK has become the first European country to approve a daily pill that could significantly change the way millions of people with obesity and type 2 diabetes are treated.
The Medicines and Healthcare products Regulatory Agency (MHRA) has authorised orforglipron, marketed as Foundayo and manufactured by pharmaceutical giant Eli Lilly. The drug belongs to the GLP-1 class of medicines that has transformed the treatment of obesity and diabetes in recent years.
Unlike some of the best-known GLP-1 treatments, which are administered by injection, Foundayo is taken as a tablet once a day. Crucially, it does not require patients to take it alongside food or water restrictions, potentially making it a more convenient option for people who are reluctant to use injectable medicines.
The drug has been licensed for adults with a body mass index (BMI) of 30 or above, or for those with a BMI between 27 and 30 who also have at least one weight-related health condition. It can also be prescribed to improve blood sugar control in people with poorly controlled type 2 diabetes.
BMI is calculated by dividing weight in kilograms by height in metres squared. Although BMI has limitations as a measure of individual health, it remains widely used by health services when assessing eligibility for obesity treatments.
Julian Beach, executive director of healthcare quality and access at the MHRA, described the approval as an important development, saying the regulator was pleased to be the first in Europe to authorise the tablet for weight management and type 2 diabetes following its assessment of the drug’s safety, quality and effectiveness.
However, approval does not mean that Foundayo is immediately available through the NHS.
The National Institute for Health and Care Excellence (NICE), which assesses whether medicines represent value for money for the health service, will now consider the treatment. Its eventual decision will help determine whether and how widely the drug is made available to NHS patients.
That distinction is important. A medicine can be licensed for use in Britain while still not being routinely funded by the NHS.
Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University, described the MHRA decision as a “big step forward” in treating obesity. He highlighted the possibility that the medicine could be available to people at lower body weights than some existing weight-loss treatments, while also suggesting it could prove cheaper than currently available alternatives.
The development comes as demand for effective obesity treatments continues to grow. Obesity is associated with a range of serious health problems, including type 2 diabetes, cardiovascular disease and other chronic conditions, placing considerable pressure on individuals and healthcare systems.
But GLP-1 medicines are not a magic solution. They require medical supervision, can have side effects and are intended for specific patients rather than as a simple cosmetic weight-loss product.
The arrival of an effective tablet could nevertheless remove one of the barriers associated with injectable treatments and potentially make long-term obesity management easier for some patients.
Foundayo’s approval also underlines Britain’s growing role in regulating a rapidly developing area of medicine. With NICE yet to decide whether the NHS should fund it, the next question is not whether the drug can be used, but who will ultimately be able to access it.
