Semaglutide and tirzepatide have been added to the WHO's updated list of essential medicines. However, the organization has not recommended using these drugs separately for treating obesity. The list also includes drugs for cancer and cystic fibrosis.

The World Health Organization (WHO) has included glucagon-like peptide-1 (GLP-1) agonists in its list of essential medicines. This was announced in a press release.

A total of 20 new drugs for adults and 15 for children have been added. The list includes active ingredients in popular drugs for diabetes and obesity: semaglutide from the Danish company Novo Nordisk (brand names: Ozempic, Wegovy), tirzepatide from pharmaceutical giant Eli Lilly (Mounjaro, Zepbound), dulaglutide (Trulicity), and liraglutide (Victoza). Their use is recommended for the treatment of type 2 diabetes mellitus in the context of cardiovascular disease, chronic kidney disease, or obesity (with a body mass index greater than 30 kg/m²).

However, the WHO has not recommended the use of these drugs alone for overweight individuals. Additional studies on their effectiveness are needed for this indication, the statement said.

The organization has once again recognized diabetes and obesity as a global problem. According to its global estimates, more than 800 million people had diabetes in 2022, and this figure is projected to rise to 1.3 billion by 2050. Meanwhile, more than 1 billion people worldwide are obese, with the most rapid spread of the disease observed in low- and middle-income countries.

The published document also notes the high cost of GLP-1 agonists, which mimic the action of a natural hormone that regulates blood sugar levels. The WHO expressed hope that adding several drugs in this class to the list would stimulate competition and lead to lower prices, especially after patent protection expires and biosimilars enter the market.

In particular, starting in 2026, the main patent for semaglutide will expire in many countries, including Brazil, Canada, China, and the United States (it should be noted that the product has secondary patents for its formula and dosing method, thanks to which Novo Nordisk's monopoly period may be extended until 2038).

Chinese pharmaceutical companies are actively developing generic versions of semaglutide for sale—11 such drugs are already completing clinical trials. The situation is different for tirzepatide—its rights are valid until 2036.

Other changes

The updated list includes the anticancer drug pembrolizumab (Keytruda from MSD, known in the US and Canada as Merck&Co.). It is approved for use in metastatic cervical cancer, colorectal cancer, and non-small cell lung cancer.

Among other approved cancer treatments is blinatumomab, intended for the treatment of lymphoblastic leukemia, which has shown significant superiority over chemotherapy in prolonging the lives of test subjects.

In addition, the WHO list has been expanded for the first time to include a treatment for cystic fibrosis. It is a combination of elexacaftor, tezaftor, and ivacaftor, which is owned by Vertex Pharmaceuticals and sold under the brand name Trikafta (Kaftrio in the European Union).

Another important addition is fast-acting insulins (lispro, aspart, glulisine) for the treatment of type 1 and type 2 diabetes. The organization justified this by the fact that conventional human insulin is being phased out by manufacturers.

Vaccines against Ebola, monkeypox, hepatitis E, respiratory syncytial virus in adults, and malaria in children are also recognized as important drugs.

 

Source: WHO