NICE has advised use of semaglutide injections for patients with prior cardiovascular conditions and excess weight to lower risk of future serious events.

Although semaglutide (Wegovy) is widely known as a weight loss treatment, the recommendation is specifically about preventing heart attacks and strokes. The injection is an additional treatment, which will be offered on top of the medicines people are already taking such as statins, and alongside a reduced-calorie diet and increased physical activity for those at high risk of another serious event.

Evidence from a clinical trial shows the injection reduces the risk of a heart attack, stroke, or cardiovascular death. Importantly, this benefit was seen early in the clinical trial, before significant weight loss occurred, suggesting the drug works directly on the heart and blood vessels, not just through weight loss.

NICE's independent committee has recommended semaglutide as an option for adults who have previously had a heart attack, a stroke, or a serious circulation problem in the legs (known as peripheral arterial disease), and who have a Body Mass Index (BMI) of at least 27 kg/m². A BMI of 27 is in the overweight range, which means this recommendation covers a different group of people than NICE's existing guidance for weight management, where the BMI threshold is higher.

“We know that people who have already had a heart attack or stroke are living with real fear that it could happen again. Today's decision gives thousands of people in that situation an extra layer of protection, on top of the medicines they are already taking. Our role is to help practitioners get the best care to people while ensuring value for the taxpayer, and we are confident this rigorous, transparent recommendation strikes the right balance between clinical effectiveness and the best use of limited NHS resources,” said Helen Knight, Director—Medicines Evaluation, NICE.

In the SELECT trial, 17,604 people who took semaglutide alongside their existing cardiovascular medicines—including cholesterol-lowering drugs such as statins—were 20 percent less likely to have a serious cardiovascular event than those who took a placebo alongside the same medicines. Both groups received standard care throughout the trial.

NICE's independent committee looked carefully at the evidence and concluded that semaglutide offers good value for the NHS. When assessing new treatments, NICE considers both how long a medicine helps people live and how much it improves their quality of life. For semaglutide, the cost of achieving those benefits came in well within the range NICE considers acceptable.