Weight loss service: 'The results have been astonishing so far' -

Pharmacist and owner Mark Burdon talks to Saša Janković about adding a weight loss clinic to the suite of services on offer at his Whickham Pharmacy in Newcastle-Upon-Tyne.

Service type: Weight loss.

Name of pharmacy: Whickham Pharmacy, Newcastle-Upon-Tyne.

Name of pharmacist: Mark Burdon.

Why did you start offering this service?

We started offering this service in 2019. I’d been looking at a range of services that the NHS won’t pay for, and at the same time I’d noticed that a lot of our customers were asking me about the Saxenda weight loss product in particular. They told me they’d been reading about it on the internet and in weight loss chat forums, and I also had the practice manager of a local GP practice ask me about it, so I decided to find out more about what it involved.

I spoke to Novo Nordisk, the manufacturer, who at that time had just started exploring setting up the service with pharmacies, and I thought it looked like a great example of something we could offer customers that they couldn’t access on the NHS.

How much did it cost to set up the service?

Novo Nordisk have provided all the training, and the PGDs where we need them, but we have had to get certain materials ourselves such as dummy packs and demo units.

What, if any, training did you or other team members have to undergo?

There’s been some staff and IT training, and we’ve built a module with Kevin Noble from PharmOutcomes, because you’ve got to do this properly and carefully as it’s about people losing weight.

In a nutshell, what does the service involve?

Saxenda is a prescription-only daily insulin injection pen for weight management in overweight and obese patients, so there only a certain subset of people who qualify and they have to motivated to do it – plus it’s expensive, so it’s not for everyone.

First I’ll talk to them about the pros and cons of weight loss, as well as explaining the importance of also having a healthy diet and lifestyle with exercise included alongside the programme. Next we go through a risk assessment form with the customer to make sure they fit the criteria for supply [adults with a BMI of 30 or greater; or have a BMI of 27 and less than 30 with weight-related health problems such as diabetes, high blood pressure, abnormal levels of fats in the blood or obstructive sleep apnoea; and are not pregnant or do not have certain medical conditions such as IBS or severe renal impairment].

Covid has changed how this works for the time being, so I’ve been doing the consultations remotely, starting people on the weekly injections, and keeping in regular contact with them to monitor their progress. It’s a simple process and the injection is not hard so it’s easy to demonstrate it online, and people are used to that now, especially during lockdown.

We can supply a month at time, which is five injections, but patients have to comply with the protocols which means losing a certain percentage reduction of overall body mass per month (based on BMI) in order to get the next supply. After that, the course lasts as long as they need it to until they hit their target weight.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

What I’m trying to focus on is building our suite of services so they link together. For example, we might have a woman using this service and through that she gets to know the pharmacy, looks at our social media, and send her husband in for a flu jab, or her kids for molluscum treatment.

How have patients responded to the service?

So far I’ve prescribed it for a few people and the results have been astonishing. We've had a few people come back for this service more than once, particularly those who stopped during the first lockdown but returned once restrictions lifted. Plus once they realise you can do more than dispense medicines and sell them over the counter, once you break that ice, they come back for lots of different things.

Roughly how often each month do you carry out the service?

The pandemic has slowed it a bit but in the end we are not running this for volume because we want it to be seen as a professional service.

How much do you charge for the service?

It works out at about £300 a month for the supply of five injections.

Roughly how much a month do you make from offering the service?

It varies. You have to factor in the cost of consumables, needles, a sharps bin; it’s a cold storage product - and the pharmacist’s time - but I’d say it’s worth doing. For me, it’s about offering a range of services that you get known for and people with come back for, rather than simply offering ad hoc services or one big hitter.

Would you recommend offering this service to other contractors?

Yes – it’s a great example of a good way to start off a service. Patients have to be motivated, and so does the pharmacist, as it’s not an easy one to set up, but nothing is these days. One of the biggest enablers for services is also getting your other local HCPs on board, but if you do it properly and tick all the boxes first it will work.