| Two years and more than a million prescriptions after Novo Nordisk's Wegovy went on sale in the US, the Danish drugmaker is finally rolling it out in Europe's biggest markets this year. As is typical, Germany — where drugmakers enjoy a relatively liberal pricing policy — is at the top of the list, due to get Wegovy next month. Today my London-based colleague Suzi Ring and I delved into a question that's already hitting hard in the US and will be particularly relevant for Europe's cash-strapped public health systems: Can patients ever hope to keep off the weight if they come off Wegovy?  Bloomberg Speaking to Germany's most prestigious Sunday newspaper, Novo Chief Executive Officer Lars Fruergaard Jorgensen made a seductive suggestion last weekend: "It could be that something changes after a few years of therapy, that the so-called set point of weight shifts downward," he said, adding that "then the lower weight can possibly be maintained without medication or with another, cheaper drug." He made somewhat similar comments to us prior to the FAS report, without being as explicit about the reset idea.
When I floated that theory to a trio of the world's leading obesity doctors recently at a conference, however, they said this was wishful thinking. Even asking about patients stopping treatment trivializes obesity, they said. "If people recognized obesity for the real disease that it is, there wouldn't be this debate," said Lee Kaplan, who retired from a four-decade career at Harvard Medical School and Massachusetts General Hospital last year and now leads the The Obesity and Metabolism Institute in Boston. Still, the UK's health-cost assessor has recommended capping treatment at two years, and self-pay will probably be the reality for many people across the continent. Whether patients will start if they know they'll have to pay forever will be important not only for Novo's balance sheet, but for the health of millions of people with obesity in Europe. — Naomi Kresge | 
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