Wegovy to Be Offered Free on NHS to Over a Million Heart Attack and Stroke Patients

More than a million people in England who have already had a heart attack, stroke or serious circulation problems in their legs will be offered Wegovy on the NHS free of charge, after health watchdog NICE approved the weight-loss jab as a preventative cardiovascular treatment.

The recommendation covers people with a BMI of 27 or above, which is classed as overweight or obese, who are already taking heart medicines such as statins. Wegovy, known generically as semaglutide, will be prescribed as an additional layer of protection alongside existing treatment, a reduced-calorie diet and increased physical activity. NHS England says around 1.2 million people could be eligible, with the rollout expected to begin within months.

The move marks a significant expansion in how the drug is used on the health service. Semaglutide is already available on the NHS for obesity treatment under the Wegovy brand and for type 2 diabetes under the name Ozempic. The new guidance is specifically about cardiovascular prevention.

Crucially, the clinical trial evidence suggests Wegovy works directly on the heart and blood vessels, not just through weight loss. Among the 17,604 trial participants, those taking semaglutide alongside their existing heart medicines had a 20% lower risk of a major cardiovascular event such as a heart attack, stroke or cardiovascular death. Notably, that benefit appeared early in the trial, before significant weight loss had occurred. A large UCL study published in the Lancet found that the benefit held regardless of how many kilograms patients lost.

Helen Knight, director of medicines evaluation at NICE, said that the evidence was "compelling." "We know that people who have already had a heart attack or stroke are living with real fear that it could happen again. The evidence from the clinical trial is compelling. It showed that people taking semaglutide alongside their existing heart medicines were significantly less likely to have another heart attack or stroke. Today's decision gives thousands of people in that situation an extra layer of protection, on top of the medicines they are already taking."

Helen Williams, NHS England's national clinical director for cardiovascular disease prevention, called it potentially "life-changing." "Used alongside a healthy diet and regular exercise, semaglutide could help prevent thousands of future major cardiovascular events and give many people the chance at a longer and healthier life."

The drug works as an appetite suppressant by mimicking the GLP-1 hormone, making people feel fuller and slowing digestion. Some users experience bloating, nausea or discomfort. Professor Robert Storey of the University of Sheffield warned that GLP-1 drugs can reduce muscle mass as well as fat, recommending that "physical activity, such as resistance training, is important to counteract potential negative effects on muscle strength."

Patients will be able to self-administer the drug at home using a pen injector. NHS treatment is currently limited to two years, though many clinicians argue it should be considered lifelong given the risk of relapse. NICE says it has reached a cost-effective pricing agreement with manufacturer Novo Nordisk.

Professor Naveed Sattar of the University of Glasgow welcomed the decision: "We now have medicines that not only reduce heart attacks, strokes and peripheral arterial disease but also simultaneously lead to meaningful weight loss — which in turn lowers the risk of many weight-related conditions. These treatments also improve patients' quality of life in a meaningful way, making this a genuine win–win."

Riyaz Patel, professor of cardiology at UCL, described it as "a really exciting development, for patients and doctors, giving us another powerful tool to reduce CVD risk," though he flagged questions about whether the NHS has the capacity to deliver the drug at such scale.