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Final thoughts Real world data can be used across the product life cycle, from optimising clinical trial design and ensuring representative recruitment to informing payer renegotiations There are still a number of challenges in collection and use of representative RWD that need to be addressed and overcome in order for this data to truly meet the evidence needs of the evolving obesity market As recommendations from recent FDA draft guidance and The Lancet Diabetes & Endocrinology Commission are disseminated and adopted, capture of vital endpoints, including further anthropometrics of weight beyond BMI and patient-reported data such as limitation of daily activities, may become prioritised in routine clinical care, improving widespread access to this data for research Mobile apps, such as Oviva and Second Nature, linked with wearable devices, are becoming increasingly prescribed and reimbursed by healthcare systems which is likely to see them reaching a wider and more diverse population beyond those proactively engaging in health and weight loss 23 Lillys recent announcement of a strategic partnership with Health Innovation Manchester to run SURMOUNT-REAL, a 5-year study to evaluate the real-world effectiveness of tirzepatide, could highlight the direction required of RWD generation to overcome existing challenges and ensure rigour in design and collection of RWE, through public-private partnerships and multi-stakeholder engagement with providers across academia, clinical and e-health 24

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