Fewer than 10% of patients in England who are eligible for what has been dubbed the “King Kong of weight loss drugs” will initially be able to access it on the NHS after officials said they would prioritise people with the highest needs.
The “difficult decision” to roll out Mounjaro slowly over 12 years was made “in order to protect other vital NHS services”, the National Institute for Health and Care Excellence (Nice) said.
The NHS spending watchdog has recommended the jab – also known as tirzepatide and made by Eli Lilly – for those with a body mass index (BMI) of more than 35 and at least one weight-related illness. This is estimated to account for about 3.4 million people.
To help the NHS manage demand, Nice said about 220,000 people could benefit from the drug in an initial three-year period. After this, the situation will be reviewed by Nice, which will provide further guidance on the rollout.
Mounjaro is a glucagon-like peptide-1 (GLP-1) agonist, a family of medications that help manage blood sugar. It was given the green light initially to help manage obesity on the NHS in June as part of draft guidance from Nice.
The once-weekly jab should be prescribed alongside a reduced-calorie diet and exercise to help people lose weight.
Other GLP-1 agonists include semaglutide – sold under the brand names Wegovy, Ozempic and Rybelsus.
Prof Jonathan Benger, the chief medical officer at Nice, said: “The world will look very different in three years which is why we’ve taken the unprecedented decision to review the way this medicine is delivered to patients then.
“Tirzepatide and other drugs like it, such as semaglutide, will help people living with obesity to lose weight, and as a result will reduce their risk of developing heart disease or having a stroke.
“But tirzepatide is not for everybody, and only those with the highest clinical need will be treated initially.
“This means many people will have to wait. We have had to make this difficult decision in order to protect other vital NHS services and also to test ways of delivering this new generation of weight loss medications.”
Final draft guidance published by Nice shows NHS England requested that Mounjaro is rolled out over a period of 12 years.
The watchdog recommends prioritising patients receiving care from specialist weight management services who will be able to access the drug within 90 days of the guidance being published on 23 December.
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NHS England will develop a plan outlining other groups of patients that will be offered Mounjaro in the next three years, according to Nice.
Prof Benger added: “We want to help NHS England carefully manage the rollout of tirzepatide to ensure that other services are not impacted in a disproportionate way.
“Whilst the funding variation sets a maximum of 12 years, Nice will review the situation again within three years and provide further advice on how the rollout of this medicine can be managed using the learning gained from the initial phase.
“This will ensure the rollout of tirzepatide reaches everyone who is eligible in a safe and effective way.”
The latest Health Survey for England shows 64% of adults were overweight or obese in 2022.
A trial by Eli Lilly – known as Surmount-5 – found patients on tirzepatide recorded a weight loss of 20.2% compared with 13.7% in patients on semaglutide.