Irish public patients still cannot get Wegovy (semaglutide) for obesity on the medical card or the Drugs Payment Scheme, even after the National Centre for Pharmacoeconomics (NCPE) said the medicine is value for money. The HSE has not published a funding decision, and a US pricing deal with Novo Nordisk has raised new questions about prices outside America.
This report sets out what the NCPE found in its assessment, completed on 13 October 2026, what the HSE has to decide next, what public funding could cost, and how the November 2025 agreement between the US government and Novo Nordisk works. It uses the NCPE's own documents first and attributes every other figure to the source that published it.
- NCPE outcome (HTA ID 25024, 13 October 2026): Wegovy should "be considered for reimbursement", but budget impact estimates "are substantial" and affordability must be considered.
- Cost per patient: €2,918 a year at the 2.4mg weekly dose, including VAT, the 9% Framework Agreement rebate and pharmacy fees (NCPE).
- Cost to the State: about €4.4 billion over five years for the full licensed population; €263 million to €3.2 billion in narrower groups (NCPE).
- HSE decision: not published. The HSE Drugs Group recommends, then HSE senior leadership decides, which RTÉ reported "may take several months".
- US deal: Wegovy at $350 a month through TrumpRx, and a company guarantee of most-favoured-nation (MFN) prices on new medicines (White House, 6 November 2025).
1. What the NCPE found
The HSE commissioned a full health technology assessment of Wegovy for weight management on 29 May 2025, after a rapid review. Novo Nordisk sent its full submission on 23 February 2026, and the NCPE completed its assessment on 13 October 2026. The company is seeking reimbursement on the Community Drug Schemes, which include the medical card and the Drugs Payment Scheme.
The assessment covers adults with a body mass index (BMI) of 30 or more, or a BMI of 27 to under 30 with at least one weight-related condition such as prediabetes, type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnoea or heart disease. Its conclusion reads: "the NCPE recommends that semaglutide (Wegovy®) be considered for reimbursement for the indication under assessment. Budget impact estimates associated with semaglutide are substantial. Consideration will need to be given, regarding the affordability of semaglutide, when making a decision regarding reimbursement."
In its plain English summary, the NCPE says "we believe the medicine is value for money". Its adjusted estimate of the cost per quality-adjusted life year (QALY) gained was €37,434 for the full licensed population, against diet and exercise alone, compared with Novo Nordisk's own estimate of €28,125. Across six patient groups specified by the HSE, the NCPE's adjusted figures ranged from €27,043 to €41,687 per QALY.
The NCPE also noted limits in the evidence: no comparative data beyond four years, and uncertainty over whether the diet and exercise support given in the STEP clinical trials matches what patients receive in Irish practice.
2. How Wegovy compares with Mounjaro
The NCPE assessed Eli Lilly's Mounjaro (tirzepatide) for the same use in December 2025. RTÉ reported that the price then submitted worked out at €5,526 to €6,214 per patient per year and was judged not cost-effective, and that Lilly has since made a new pricing offer. NCPE clinical director Professor Michael Barry told RTÉ that Wegovy is cheaper than Mounjaro. The NCPE's Wegovy summary states that tirzepatide "remains under consideration for reimbursement by the HSE". We covered that process in our report on the HSE's Mounjaro funding decision.
| Item | Wegovy (semaglutide) | Mounjaro (tirzepatide) |
|---|---|---|
| NCPE HTA ID | 25024 | 24024 |
| Assessment completed | 13 October 2026 | 3 December 2025 |
| Annual cost per patient | €2,918 (2.4mg weekly); €4,370 (7.2mg weekly) | €5,526 to €6,214 (as reported by RTÉ) |
| Outcome | Considered for reimbursement; affordability to be weighed | Not cost-effective at the submitted price (RTÉ); new Lilly offer since |
| HSE decision | Not published | Not published |
3. What public funding could cost
The NCPE gives the price to wholesaler of a 2.4mg Wegovy pen, which holds four weekly doses, as €169.13. That leads to the annual figure of €2,918 per patient. Because so many adults meet the licensed criteria, the total is large. In the full licensed population, the NCPE puts the five-year net drug budget impact at approximately €4.4 billion, including VAT. Using its own adjusted assumptions in the six HSE-specified groups, the estimate ranges from €263 million for people with a BMI of 40 or more and at least one weight-related condition, to €3.2 billion for everyone with a BMI of 30 or more.
That range explains why the NCPE flagged affordability: the total depends heavily on which patients are covered. Whether the HSE limits funding to a narrower group, and at what price, has not been disclosed. At present the only GLP-1 medicine reimbursed for weight management is liraglutide (Saxenda), under a HSE managed access protocol for adults with a BMI of 35 or more who have prediabetes and a high cardiovascular risk.
4. What happens next at the HSE
The NCPE advises; it does not decide. Its report, recommendation and a patient organisation submission from the Irish Coalition for People Living with Obesity go to the HSE, which must also apply the criteria in the Health (Pricing and Supply of Medical Goods) Act 2013. According to RTÉ, the HSE Drugs Group will consider the assessment and make a recommendation to HSE senior leadership, and "this may take several months". No date has been announced. The HSE's patient page on obesity medicines still states that "Wegovy is not covered by the medical card, Long-Term Illness Scheme and Drugs Payment Scheme." Background on the policy debate is in our analysis, The GLP-1 dilemma.
5. How the US most-favoured-nation deal works
On 6 November 2025 the White House announced agreements with Novo Nordisk and Eli Lilly. It said Ozempic and Wegovy would fall from $1,000 and $1,350 a month to $350 through its TrumpRx website, and that Medicare would pay $245, with patients paying a $50 monthly co-pay. The two companies also agreed to "guarantee MFN prices on all new medicines that they bring to market" and to repatriate increased foreign revenue on existing products. Novo Nordisk committed an additional $10 billion investment in the US.
| Product or channel | Before | Under the deal |
|---|---|---|
| Wegovy, TrumpRx | $1,350 | $350 |
| Ozempic, TrumpRx | $1,000 | $350 |
| Medicare price (GLP-1s listed) | Not stated | $245, patient co-pay $50 |
| Oral GLP-1 starting dose, if approved | Not stated | $150 |
MFN pricing ties US prices to those paid in other wealthy countries. Reuters has reported industry concern that this could disrupt European launches, because a low price agreed in a European market could feed back into a lower US price. Novo Nordisk chief executive Mike Doustdar gave a different view in May 2026, telling Reuters: "We are considering MFN obviously as part of our planning, but it's not a limiting factor." Reuters reported that the company was pushing ahead with the Wegovy pill outside the US in the second half of 2026.
Novo Nordisk has not, in any public statement we could find, set out how the US agreement affects its Irish reimbursement application for Wegovy injection, which is already on the Irish market and is not a new launch.
6. The Irish manufacturing link
Novo Nordisk's main Irish site is in Monksland, Athlone. On 2 March 2026 the company announced a €432 million investment in the tabletting facility there to expand capacity for oral GLP-1 medicines, with the site acting as a hub for markets outside the US. It said the site has 260 employees, the project would create up to 500 construction jobs, and work would finish in phases from the end of 2027 through 2028. See our earlier report on the Athlone expansion and the Novo Nordisk company profile.
7. What it means for patients now
Wegovy can be prescribed privately in Ireland by a doctor and dispensed by a pharmacy, but patients pay the full cost themselves. Private prices vary and were not set out in the official sources used for this report. The HSE advises people not to buy obesity medicines online because "you cannot be sure if they are real or fake". Anyone considering a weight-loss medicine should speak to their GP or pharmacist about whether it is suitable for them. More detail on the medicine is on our semaglutide drug page, and the wider competitive picture is in our obesity power rankings.
Frequently Asked Questions
Is Wegovy free on the medical card in Ireland?
No. The HSE states that Wegovy is not covered by the medical card, the Long-Term Illness Scheme or the Drugs Payment Scheme. The NCPE has recommended that the HSE consider funding it, but the HSE has not published a decision.
When will the HSE decide on Wegovy?
No date has been announced. The HSE Drugs Group must first make a recommendation to HSE senior leadership, and RTÉ reported that this may take several months.
Does the US pricing deal set Irish prices?
No. Irish prices are agreed between the company and the HSE under Irish law. The US deal commits Novo Nordisk to MFN prices on new medicines in the US, which links US prices to other countries. Novo Nordisk's chief executive said in May 2026 that MFN is part of planning but "not a limiting factor".
Outlook
The next step is a recommendation from the HSE Drugs Group. Things to watch are whether the HSE funds Wegovy for all eligible adults or for a narrower high-BMI group first, whether it decides on Wegovy and Mounjaro together, and whether Novo Nordisk sets out publicly how US pricing rules affect its offer to Ireland. Any change will be reported here.
Sources
- National Centre for Pharmacoeconomics, Semaglutide (Wegovy®). HTA ID: 25024, assessment completed 13 October 2026
- NCPE, NCPE Assessment Summary: Semaglutide (Wegovy®), 13 October 2026
- NCPE, Plain English Summary: Semaglutide (Wegovy®), October 2026
- NCPE, Tirzepatide (Mounjaro®). HTA ID: 24024, 3 December 2025
- HSE, Obesity: treatment with medicines, page last reviewed 5 December 2025
- The White House, Fact sheet on most-favoured-nation pricing agreements, 6 November 2025
- Novo Nordisk, Novo Nordisk announces more than 400 million euro expansion in its manufacturing facility in Athlone, Ireland, 2 March 2026
- RTÉ News, Fergal Bowers, Wegovy assessment for the HSE, 15 October 2026, updated 16 October 2026
- Reuters via MarketScreener, Stine Jacobsen and Maggie Fick, Novo Nordisk's first-quarter profit beats forecasts, 6 May 2026
Cover image: AI-generated illustration of the Wegovy pen and carton. It is not a photograph of the real product or its packaging.
