Can society afford not to subsidize Wegovy?

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There was a decision this week that triggered emotions: the Dental and Pharmaceutical Benefits Agency (TLV) refused to subsidize the weight-loss drug Wegovy. In other words, patients must continue to pay the full price for their medications.

Behind the decision lies an economic reality that most of us rarely think about.

Every time, man When you pick up a prescription medicine, you usually only pay part of the price. The rest is covered by high-cost protection, which is financed by the regions with tax money and government subsidies. For 2025, the total budget for prescription drugs in the country was SEK 47.5 billion.

This is where the appetite suppressant Wegovy becomes a difficult equation. The drug is effective, leading to an average weight loss of 15 percent, but it is expensive. A monthly treatment with the highest dose now costs around SEK 2,700.

Approximately 1.6 million Swedes are obese (BMI 30 and above) and could be eligible for the drug. If everyone received Wegovy as part of the drug grant, the bill would be a staggering 55 billion crowns, more than Sweden’s total prescription drug budget.

It can be asked in relation to other government expenditure. According to Dagens Industri, for example, these include state subsidies to the police, the Säpo, the public prosecutor’s office and the Ecocrime Agency last year.

But now no one believes that so many people would have access to the drug. The company Novo Nordisk, which produces Wegovy, also applied for a subsidy only for three groups of patients with a BMI of 35 or more. That corresponds to 450,000 Swedes and, according to TLV, would cost around 15 billion per year.

However, doctors have the right to free prescription and can prescribe Wegovy to patients with a lower BMI if they believe it is best for the patient.

Now here we come to the main reason why TLV says no. The authority fears that Wegovy would be printed far beyond the defined groups and that costs would then be difficult to control. This is known as subsidy slippage. According to TLV, the worst-case costs could be between SEK 15 and 55 billion per year.

This, in turn, has angered the medical community, who feel their professionalism and judgment are being questioned.

“Doctors are allowed to prescribe many types of medication, including very expensive preparations that are classified as medicines, but here they stop by saying that we cannot adhere to the indication,” obesity doctor Ylva Trolle Lagerros said in an interview.

The drug budget of the regions should be enough for everyone. The point of TLV is that a drug like Wegovy can replace other treatments – even life-saving drugs for cancer or rare diseases, for example.

At the same time, the societal costs for people with overweight and obesity (obesity) already amount to up to SEK 125 billion per year.

TLV sees three possible paths to getting approval for Wegovy and other obesity drugs in the future: special workplace codes that would limit prescribing rights to certain clinics, a national registry that allows for safer follow-up care, and a requirement (like in Norway) that doctors apply for an individual subsidy for each patient.

The Wegovy decision forces us to ask the question: Who gets access to new, expensive drugs when the bill is ultimately shared? And while we debate principles and priorities, the treatment of obesity remains unequal. Those who can afford it can pay for it out of their own pocket. Whoever doesn’t have it will be without it.

Read more:
This is how much weight you gain when you stop taking obesity medications
Few take advantage of reimbursement for obesity medications
It determines which diet you should choose – DN reviews weight methods