Novo Nordisk (China) Pharmaceuticals Co., Ltd.

Abstract

In recent years, the prevalence of overweight and obesity in China has shown a significant upward trend, becoming a major public health issue requiring urgent resolution. According to the “Report on the Nutrition and Chronic Disease Status of Chinese Residents” released by the National Health Commission, between 2015 and 2020, the overweight rate among adults increased from 30.1% to 34.3%, and the obesity rate rose from 11.9% to 16.4%; among adolescents aged 6–17 years, the overweight rate climbed from 9.6% to 11.1%, and the obesity rate went up from 6.4% to 7.9%. The prevalence of overweight and obesity among children under 6 years old also exceeded 10%. Obesity not only seriously threatens the health and well-being of the population but also imposes a heavy burden on socio-economic development. According to data from the World Obesity Federation, in 2021, approximately 228,000 premature deaths in China were attributed to obesity. In the same year, the loss of healthy life years due to obesity exceeded 8.5 million personyears. From a socio-economic burden perspective, medical costs related to overweight and obesity in China reached USD 36.8 billion (approximately RMB 262.2 billion) in 2020; it is projected that this figure will reach USD 82.3 billion (approximately RMB 589.8 billion) by 2030.

Faced with the significant challenges posed by obesity, the Chinese government has attached great importance on addressing overweight and obesity, continuously refining the weight management policy system, and establishing a whole-life-cycle policy framework covering prevention, diagnosis, treatment, and management. Particularly under the guidance of the national “Weight Management Year” initiative, China has achieved notable progress in obesity prevention, control, and the development of its diagnosis and treatment system. However, despite these advancements, the current state of diagnosis, treatment, and management of obesity in China remains in its early stages, presenting multiple practical challenges. These are mainly reflected in the lagging standardized construction of national-provincialcity-county level weight management centers/clinics and the insufficient coverage of innovative anti-obesity medicines by the multi-level medical security system, which have affected the effectiveness of obesity diagnosis and treatment and the accessibility of drugs to a certain extent.

Specifically, although medical institutions at various levels and regions have actively responded to the policy call to promote the construction of weight management centers/clinics, the lack of unified construction standards has led to large differences in construction models, department allocation, personnel qualifications, and equipment requirements among medical institutions. In addition, no charging mechanism has been established for weight management-related diagnosis and treatment services, restricting the professionalization and sound and sustainable development of weight management services. The hospital listing standards for weight management clinics are also incomplete, with no specific drug catalog guidance for such clinics. As self-funded medicines, anti-obesity medicines face high barriers to hospital access, resulting in a low allocation rate of innovative drugs. Meanwhile, the capability building of grassroots weight management is insufficient, and problems in personnel capability, referral mechanisms, management systems, and support systems have further widened the service capability gap between regions and urban-rural areas, restricting the large-scale and standardized promotion of obesity prevention and treatment. Furthermore, as a chronic disease, obesity requires long-term medication, placing considerable financial pressure on patients. Basic Medical Insurance (BMI) does not cover innovative anti-obesity medicines, and the coverage of multi-level medical security measures such as “Huiminbao” (city-specific supplement insurance) and commercial insurance is also limited, resulting in markedly insufficient protection for patients.

In response to the above problems, policy breakthroughs and systematic solutions are urgently needed.

First, strengthen the standardized construction of the weight management diagnosis and treatment system and weight management capability of medical institutions at all levels, innovate outpatient charging mechanisms, and ensure hospital listing. It is recommended to accelerate the construction of healthy weight management centers and clinics in medical institutions at all levels, promote the formulation of unified construction standards for healthy weight management clinics, clarify core elements such as department allocation, personnel qualifications, and equipment requirements to provide clear guidance for medical institutions; include innovative weight management service packages in medical service price items to fully reflect the service value of medical staff; at the same time, establish a hospital hospital listing mechanism for innovative anti-obesity medicines, smooth the hospital access process of these drugs, and ensure that medical institutions can timely allocate innovative drugs for obesity treatment.

Second, establish a multi-level healthcare security system for obesity in a phased manner. In the short term, efforts should be directed toward promoting the widespread inclusion of innovative anti-obesity medicines in city-specific “Huiminbao” (city supplement insurance) drug lists to expand drug coverage for patient groups. In the mid-term, promote the inclusion of innovative anti-obesity medicines in commercial health insurance-related innovative drug catalogs or lists to provide patients with more diversified coverage options. In the long term, explore reasonable payment methods, and gradually achieve the coverage of innovative anti-obesity medicines by BMI on the basis of fully evaluating the clinical value and economic efficiency of such drugs.

Weight management is a long-term and complex systematic project that requires the joint efforts of the government, medical institutions, enterprises, and all sectors of society to contribute to building a full-population and full-life-cycle weight management ecosystem featuring “government leadership, industry participation, and nationwide co-construction.”

Download the full report：Implementing the “Weight Management Year” Initiative to Advance Comprehensive Weight Management Care and Healthcare Coverage