More than 90 per cent of eligible patients in England will initially not be able to access the so-called “King Kong of weight loss drugs” on the NHS, as officials prioritise those with the highest needs. The National Institute for Health and Care Excellence (Nice) explained that this “difficult decision” was made to safeguard other crucial NHS services.
Nice has endorsed Mounjaro, also known as tirzepatide and produced by Eli Lilly, for individuals with a body mass index (BMI) over 35 and at least one weight-related health issue, which is estimated to include about 3.4 million people. To assist the NHS in managing demand, Nice stated that approximately 220,000 people could benefit from the drug over an initial three-year period.
After this, Nice will review the situation and offer further guidance on the rollout. Mounjaro is a glucagon-like peptide-1 (GLP-1) agonist, a type of medication that helps regulate blood sugar levels.
It was first approved for use on the NHS to manage obesity in June, according to draft guidance from Nice. The once-weekly injection should be prescribed alongside a reduced-calorie diet and exercise to aid weight loss.
Other GLP-1 agonists include semaglutide, marketed under the brand names Wegovy, Ozempic and Rybelsus, reports Surrey Live.
Professor Jonathan Benger, the chief medical officer at Nice, has emphasised: “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.” Nice’s final draft guidance reveals that NHS England requested Mounjaro to be rolled out over 12 years.
The watchdog advises focusing first on patients attending specialist weight management services – approximately 220,000 individuals – who are set to get access to the drug within 90 days of the guidance release on December 23. NHS England is tasked with devising a plan for additional patient groups to be offered Mounjaro within the coming three years, says Nice. Professor Benger further stated: “We want to help NHS England carefully manage the roll out of tirzepatide to ensure that other services are not impacted in a disproportionate way.
“While 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 roll-out of this medicine can be managed using the learning gained from the initial phase. This will ensure the roll out of tirzepatide reaches everyone who is eligible in a safe and effective way.”
The latest Health Survey for England shows that 64% of adults were overweight or obese in 2022. However, Dr Kath McCullough, NHS England’s national speciality adviser for obesity, cautioned that weight loss jabs “are not a magic bullet”.
She stated: “Obesity is one of the greatest public health issues facing the NHS and weight loss drugs, such as tirzepatide, are an important tool in helping people lose weight while also reducing the risk of other serious long-term conditions such as diabetes, strokes and heart attacks.
“However, on their own, weight loss drugs are not a magic bullet. They need to be prescribed by a healthcare professional alongside programmes that help people lose weight and live healthier lives by making changes to their diet and physical activity – and it’s also crucial that they are prioritised for those who need them most.
“This guidance enables the NHS to implement a phased roll out of tirzepatide to patients with the highest clinical need in a safe and effective way, while also protecting access to the NHS services that all patients rely on.”
This follows a trial by Mounjaro manufacturer Eli Lilly, dubbed Surmount-5, which revealed that patients on tirzepatide experienced a weight loss of 20.2%, compared to the 13.7% recorded in patients on semaglutide.