By LOIS WATSON - Sunday Star Times | Sunday, 17 February 2008

The government's drug-buying agency won't use taxpayer funds to subsidise Reductil because it doubts the obesity drug's effectiveness.

Despite a growing problem with obesity in New Zealand, Pharmac has turned down Abbott Laboratories' application to have sibutramine hydrochloride (Reductil) added to the list of government-subsidised drugs.

Obesity drugs are subsidised in many other parts of the world, including England, where more than a million prescriptions for such drugs were written last year at a cost of around $120 million.

Pharmac communications manager Simon England told the Sunday Star-Times that the agency's medical advisory committee had considered whether the cost of Reductil for the treatment of severe obesity should be subsidised by taxpayers, but had advised against it.

He said clinical trials suggested patients experienced weight loss only while they were taking the drug and they could expect to lose only about 5% of their body weight.

The committee questioned whether such weight loss would result in any substantial improvement in clinical outcomes or quality of life over an extended period of time. It also pointed out that unless "significant and sustainable lifestyle changes" were made, rebound weight gain was likely once the patient stopped taking Reductil, which suppresses hunger by blocking the nerve cells that control serotonin in the brain.

Health Ministry figures from 2004 estimate obesity costs the health sector about $460m a year. More recently officials have said that between 1500 and 3000 people could die over the next five years from obesity-related complications.

Only 9 per cent of men and 11 per cent of women were considered obese in 1977, but by 2003 that figure had risen to 20 per cent and 22 per cent respectively.

Reductil is heavily marketed in New Zealand through direct-to-the-consumer advertising. A month's prescription costs around $70 and the drug company claims on its website that 15 million people in more than 70 countries have used the one-capsule-a-day treatment. However, it would not release New Zealand figures. Several years ago it was reported 17,000 New Zealanders took the drug.

Xenical, which works by blocking about 30 per cent of fat eaten by users, is the other obesity drug available in New Zealand. A new pill GlaxoSmithKline's Alli, which claims to improve weight loss by 50 per cent could be available in New Zealand by the middle of next year.

Obesity Action Coalition executive director Leigh Sturgess was not surprised Pharmac had turned down the funding application.

While some fat people would benefit from such medication, there was more to be gained from putting resources into changing lifestyles and creating an environment which encouraged people to make healthy choices.

"We've got to get past `let's take a pill and solve all our problems'. It's not the answer," Sturgess said