The weekly jabs were launched this year, but they cost at least €200 a month and are not covered by the HSE.
Michael Barry, head of the National Centre for Pharmacoeconomics, which assessed the cost effectiveness of drugs and recommended they be included in HSE schemes, said the national drugs budget is currently €4bn, but if the two jabs were made available to everyone who would benefit, it would jump to €10bn.
It means that choices will have to be made around who will be eligible for the treatments.
Mr Barry said around one million people in Ireland are estimated to have a BMI over 30 and many of these could potentially benefit from the jabs.
Making them available to this number of people “is unaffordable and not going to happen,” he told the annual general meeting of the Irish Medical Organisation (IMO).
“These drugs are currently being assessed and we anticipate it will be completed at the end of the year or the start of next year at the latest,” he said. “That is when the decision making will need to be made.”
It may mean the jabs will only be available to people with a BMI of 40 or over, he added. Mr Barry said the cardiovascular benefits will have to be taken into account when assessing the drugs.
The discussion may quickly move from weight loss to cardiovascular disease prevention, he added.
The advances in this area mean that an oral weight-loss version has been now manufactured in the United States.
Saxenda, a weight loss treatment which has been available here for some time and is injected once a day, is already subject to restrictions. Just 51pc of patients for whom it is recommended by doctors are approved.
Around 54,000 people are currently prescribed Ozempic for diabetes, costing €7.4m a month.
He also called for an honest debate around claims by pharmaceutical companies about delays in approving new cancer drugs.
“It is always portrayed that there is a delay of up to two years and it is the HSE’s fault,” he said. “It is not, I have no problem in saying that these are high-cost drugs and we should be looking for value for money.
“I think people need to be honest and acknowledge a significant amount of the delay is due to the companies themselves and they launch in bigger markets first. That is fine – it is up to themselves. The delays are not entirely down to the HSE.”
He said cancer is the most important area for the drugs industry and up to 40pc of all the assessments we do are for cancer drugs. Last year, cancer drugs approved were initially priced at €490m but negotiations reduced the bill by €174m.
There needs to be price negotiations, Mr Barry stressed, adding: “We are dealing with vast sums of money.”
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