Estonia's Health Insurance Fund weighs obesity drug coverage for Wegovy

Estonia's Health Insurance Fund is considering extending compensation for the weight-loss drug Wegovy to patients diagnosed with obesity, not just diabetes. A cost-benefit analysis commissioned from the University of Tartu is expected by autumn, potentially enabling coverage to begin as early as spring 2027. Annual costs could range from €18 million to €500 million depending on which patient groups qualify.

Estonia's Health Insurance Fund (Haigekassa) is reviewing whether to extend state compensation for Wegovy, currently covered only for type 2 diabetes patients, to people diagnosed with obesity as well. The decision hinges on an updated cost-benefit assessment requested from the University of Tartu, with results expected this autumn.

Background: A Drug in High Demand

Danish pharmaceutical company Novo Nordisk, the maker of both Ozempic and Wegovy, submitted a formal application to the Health Insurance Fund earlier this spring, requesting that Wegovy be added to the list of compensated medicines for obesity treatment, not just diabetes management.

At present, Estonia reimburses GLP-1 receptor agonists only for diabetic patients, and even then only after other treatments have been tried. Those with an obesity diagnosis must pay out of pocket: Ozempic costs around €90 per month, Wegovy €150, and the newer Mounjaro €180, making long-term treatment financially out of reach for many.

What the Experts Say

Endocrinologist Kristina Isand argues that the medical community's approach needs to shift. «We need to change the way people think about this. Obesity is just as much a chronic disease as type 2 diabetes,» she said. «When I prescribe this medication to a diabetes patient, they understand they will need it for life and accept that without question. If we start treating obesity as a chronic illness, the same logic applies.»

Isand also highlighted the broader therapeutic value of this class of drugs. «GLP-1 and GIP receptor agonists don't just treat obesity, they can induce remission in type 2 diabetes and produce excellent results in fatty liver disease. They normalise blood pressure, improve sleep quality, benefit the cardiovascular system, and protect the kidneys. These may be among the most significant medicines of this century in terms of adding healthy years to people's lives,» she said.

The Review Process

Getter Hark, head of the Health Insurance Fund's drug reimbursement service, confirmed the application is under active consideration. «Before making a funding decision, we asked the University of Tartu to conduct a new evaluation. Experts will weigh all the health benefits the drug provides against its costs, not just direct treatment expenses, but also savings from preventing obesity-related complications,» she explained.

Hark noted that the previous report on the drug was prepared three years ago, and that economic conditions, drug pricing, and the active substances themselves have all changed since then, making an updated analysis essential.

If the university completes the report by autumn, Hark projects that compensation could come into effect the following spring. The financial stakes, however, are considerable. «Given the number of potential patients, costs would likely be enormous. The previous report estimated annual expenditure ranging from €18 million to €500 million, depending on which patient groups are covered,» she said, adding that the final decision will depend on the commission's recommendations and available resources.