Which drug has a higher likelihood of insurance coverage: Wegovy or Saxenda?

In the UK, coverage depends on NHS commissioning rather than insurance, and NICE now recommends Wegovy within specialist services. Saxenda has more limited NHS use. In private healthcare or in other countries, coverage varies by insurer, but newer guidance tends to prioritise Wegovy because of its stronger results.

The UK context: NHS commissioning, not insurance

Unlike in the United States, where health insurance policies determine which drugs are covered, the UK relies on the NHS commissioning system. Here, decisions are made centrally by NICE (the National Institute for Health and Care Excellence), which reviews clinical evidence and cost-effectiveness before recommending whether the NHS should fund a medicine. This means that access depends less on insurance and more on whether a treatment is judged to provide value for money within NHS budgets.

NICE guidance on Wegovy

In 2023, NICE recommended Wegovy (semaglutide 2.4 mg weekly) for use in adults with a BMI over 35 and at least one weight-related condition, or in some cases with a BMI over 30 if criteria are met. This decision means that Wegovy is now available through NHS specialist weight-management services. The recommendation was based on strong evidence from the STEP clinical trials, which showed sustained average weight loss of around 15% at 68 weeks, alongside improvements in blood pressure and cholesterol.

NICE guidance on Saxenda

Saxenda (liraglutide 3 mg daily) was approved earlier, but its NHS role has been narrower. NICE guidance allowed Saxenda for adults with obesity and prediabetes who were at high risk of cardiovascular disease, but access was more restricted. Daily injections and more modest trial results — around 6–8% average weight loss in the SCALE trials — meant Saxenda did not become as widely commissioned as semaglutide. Today, Saxenda is available privately but is less likely to be funded within NHS weight-management services compared with Wegovy.

Private healthcare and insurance coverage

In private UK healthcare, coverage is less standardised. Many private clinics offer both Saxenda and Wegovy, but patients usually pay out of pocket. Traditional private health insurance policies in the UK rarely cover weight-loss medicines, although some employers are beginning to add obesity care to their benefits packages. Where cover exists internationally, insurers are increasingly more willing to reimburse Wegovy because of its strong clinical data and proven long-term benefits.

Why Wegovy is prioritised

From a clinical and economic perspective, Wegovy’s advantage is clear. It offers stronger weight loss than Saxenda, has longer-term evidence (including sustained results at two years in STEP-5), and has also demonstrated cardiovascular benefits in the SELECT trial. These outcomes make it more attractive to payers — whether that’s the NHS or private insurers — who are looking for treatments that reduce long-term healthcare costs.

Global perspective

In the United States, both Wegovy and Saxenda are licensed, but insurers vary in what they cover. Some health plans include Wegovy because of its stronger evidence, while others exclude weight-loss medicines altogether. In Europe, the situation is similar: Wegovy is increasingly commissioned where budgets allow, while Saxenda is being phased out in some places as semaglutide takes priority.

Key takeaways

In the UK, Wegovy is now the GLP-1 medicine more likely to be funded through NHS weight-management services, while Saxenda has limited NHS use. In private and international settings, coverage depends on the insurer, but newer policies tend to prioritise Wegovy because of its stronger trial results and long-term health benefits. For most patients, this makes Wegovy the more accessible option where coverage is available.