The World Health Organization has officially added GLP-1 medications to its essential medicines list for treating type 2 diabetes, marking a significant step toward expanding global access to these breakthrough therapies. The WHO announced that it has included the active ingredients in Novo Nordisk's Ozempic (semaglutide) and Eli Lilly's Mounjaro (tirzepatide) specifically for treating type 2 diabetes in conjunction with established cardiovascular disease, chronic kidney disease, or obesity.
The essential medicines list, consisting of 523 medicines for adults and 374 for children, represents a catalogue of drugs the WHO believes should be available in all functioning health systems. According to the organization, adding a drug to this list helps increase access to patient populations in low-income areas.
Strategic Decision on Weight-Loss Exclusion
Despite the widespread popularity of GLP-1 medications for weight management, the WHO stopped short of adding them to treat obesity alone, maintaining the same position it took in 2023. This decision comes even as WHO data shows that more than one billion people are affected by obesity globally, and in 2021, more than 3.7 million people died from conditions linked to being overweight or obese—a number that exceeds the combined deaths from malaria, tuberculosis, and HIV.
The committee said this decision provided clear guidance on which patients would most benefit from the therapies, focusing on the substantial diabetic population. According to WHO data, more than 800 million people around the world were living with diabetes in 2022.
Addressing Price Barriers
High medication costs remain a critical obstacle to patient access. "High prices of medicines like semaglutide and tirzepatide are limiting access to these medicines," the WHO statement noted. Dr. Lorenzo Moja, head of the WHO secretariat overseeing the list, told Reuters that "rather than letting price be a disqualifying factor, the committee views inclusion in the essential medicines list as a potential catalyst for access."
The WHO emphasized that encouraging generic drugmakers to produce these medications would help improve accessibility, particularly as patents begin to expire on the drugs next year. Currently, even when purchasing these drugs directly from manufacturers through their digital pharmacies, they can still cost hundreds of dollars monthly.
Broader Essential Medicines Updates
The WHO also added several other high-impact medications to the essential medicines list. Vertex Pharmaceuticals' combination therapy for cystic fibrosis, Trikafta or Kaftrio, was included despite years of criticism from activists regarding its high price and limited accessibility. Additionally, Merck's top-selling cancer immunotherapy drug Keytruda was added for treating cervical cancers, colorectal cancers, and non-small cell lung cancers that have metastasized.
The list further includes rapid-acting insulin analogues, manufactured by companies including Novo Nordisk and Eli Lilly, for treating type 1, type 2, and gestational diabetes.
"The new editions of essential medicines lists mark a significant step toward expanding access to new medicines with proven clinical benefits and with high potential for global public health impact," said Yukiko Nakatani, WHO's assistant director-general for Health Systems, Access and Data.
Market Impact and Access Challenges
The popularity of GLP-1 medications has created complex market dynamics. While initially developed for diabetes treatment, these drugs have become massively popular due to their appetite-reducing effects and approval for obesity treatment. This demand has resulted in high prices and drug shortages in some markets.
Insurance coverage patterns have also evolved, with providers initially quick to offer programs including GLP-1 medications for weight-loss last year, though this trend has started to reverse in 2024. This shift has forced many patients to adjust either their dosage or finances to afford out-of-pocket costs, while insurance providers remain more likely to cover the drugs when prescribed for diabetes.
