GLP-1 Drug Demand Raises Access Debate: Should These Medicines Continue to Be Prescribed?

So what is GLP-1? GLP-1 receptors mimic hormones released after eating to reduce appetite. Originally, it was developed to treat type 2 diabetes but now can also be prescribed for helping people lose weight. Recently, it has featured in the news due to some concerns. In the UK, the demand has increased significantly as more patients meet the eligibility standards. There are debates on the cost on the NHS, long term use and if these drugs should be relied upon. To weigh the for and against I will be using the four core principles of medical ethics.

Autonomy

Do we know enough about the medicine to fully educate the patient to guide them to make an informed decision? Starting off with what we know, this treatment is generally more effective than lifestyle changes alone for many eligible patients. We also know that it lowers blood glucose for people with type 2 diabetes which can benefit their health greatly.  Side effects we can establish include nausea, vomiting, diarrhea and constipation. They become more noticeable when treatment begins or dosage increases which is how researchers understood this. Additionally, they are only suitable to factors such as BMI, medical history and weight related health conditions as well as being used alongside lifestyle changes such as a healthy balanced diets , physical activity and behavioral support. However, researchers are still learning very long term effects and the best duration of treatment for different patients to best suit their needs. Overall, what we do know outweighs what we do not so this respects autonomy as doctors will give the patient the information they need to make their own decision. 

Beneficence and Non- Maleficence 

Beneficence is a value that ensures that the treatment is in the “best interests” of a patient. Non- maleficence  is, before prescribing we can ensure the risks and side effects do not outweigh the benefits and chances of health improvement. Now how does this treatment benefit the patient? It improves blood glucose with this with type 2 diabetes and can improve quality of life, mobility and mental wellbeing as weight can hinder these. Also, links to reduced risk of obesity related conditions like cardiovascular disease because of reduced appetite supporting weight loss. Mentally, losing weight can boost self esteem and image which can increase motivation to live a fulfilling, healthier life.  

On the other hand, possible harms, which could lead to maleficence, is matters such as side effects, risks and uncertainties. Not every patient can meet the criteria so doctors must assess health honestly and transparently. GLP-1 has only been around since its creation in 2005, so long term effects for the unforeseeable future have not been observed or discovered yet. Additionally, side effects can be really challenging and frustrating possibly leading to poor mental health. This has to be taken into account before prescribing this drug.

Justice 

Justice in the healthcare system should promote fair access to resources required to improve health if a patient needs/wants it. There has been controversy surrounding the cost on the NHS of the drug and patients should receive the treatment if they meet the criteria regardless of the NHS ability to pay for it. Additionally, everyone should have the same opportunity to benefit from this treatment no matter where they live or their financial status. Decision makers must consider whether funding GLP-1 medicine improves health of those who take it.

I think GLP-1 medicines are an important addition to obesity management because they can improve health outcomes for many patients. However, they should be used alongside lifestyle support rather than as a replacement for healthy habits. As a future doctor, I think it’s important to balance the benefits for individual patients with the fair use of NHS resources and to make decisions based on the best available evidence.