Weight-loss drugs offer a classic conundrum for local Integrated Care Boards;
on one hand, the treatment is cost-effective as despite its high price the reduction in future NHS expenditure on that patient drops even more.
But, long-term savings do not pay for immediate costs, and so many ICBs have set threshold criteria for weight loss drugs higher that recommended by NICE, leading (inevitably) to a 'post-code lottery'...which is what you get in a devolved quasi market!