Slimming drug Wegovy should not be included in the basic insurance package because its long-term health benefits are unclear and it will also boost costs, the Dutch healthcare institute has said in recommendations to health minister Fleur Agema.

Pharmaceutical company Novo Nordisk filed a request for Wegovy to be admitted to the basic insurance package last year.

Wegovy, which contains the appetite suppressant semaglutide, is effective, the organisation said, but it is unclear which patients will benefit most from its use.

There is a worldwide shortage of semaglutide, which also lowers blood sugar in type 2 diabetes patients, and is sold under the brand name Ozempic. The run on the medicine by people wanting to lose weight has meant that diabetes sufferers have had to turn to alternative drugs.

There are also unanswered questions about the long-term effectiveness of the drug in people with obesity. A majority of people on Wegovy lose an average 5% of their body weight while 30% lose some 10% but little research has been done into what happens if people are taken off the drug, the institute said.

The agency also fears the medication will be widely prescribed, leading to costs of up to €1.3 billion a year.

Some 7 million people in the Netherlands are overweight, of whom 14% are obese. “We had to ask ourselves if we were going to give this expensive medication to a large group of people for life without knowing how it can best be used,” agency chairman Sjaak Wijma said in a statement.

Wijma said the the solution to the obesity crisis cannot be the sole responsibility of the healthcare system.

What is needed is a political debate about how society can prevent and combat obesity, he said. “The necessary measures to make society healthier are not forthcoming,” he said.

Doctors will still be able to prescribe Wegovy but patients will have to pay for the drug themselves. According to news website Nu.nl a year’s supply costs €2,750.