The weight loss jab Mounjaro will soon be made available to nearly a quarter of a million NHS patients, according to proposals made by the National Institute for Health and Care Excellence (Nice). Previously, it was only available on the NHS for patients with diabetes.
Authors
Zoe Edwards
Research Lead/Advanced Clinical Practitioner/Senior Research Fellow, University of Bradford
Jonathan Silcock
Associate Professor in Pharmacy Practice, University of Bradford
Liz Breen
Director of the Digital Health Enterprise Zone (DHEZ), University of Bradford, Professor of Health Service Operations, University of Bradford
Under Nice's proposals, the drug will gradually be rolled out over the next three years. Access to it will first be prioritised to patients who are severely obese and have at least three weight-related health problems - for example, cardiovascular disease, hypertension, high cholesterol and sleep apnoea.
There are plans to increase NHS access to more patients after the initial three-year period. It will also remain available for patients with diabetes.
This recent approval provides new treatment options for people with obesity - but how effective it is will depend on whether supplies can keep up with anticipated demand.
What is Mounjaro?
Mounjaro is the UK brand name of the drug tirzepatide, which, until now, has only been prescribed on the NHS for patients with diabetes to help control blood sugar and encourage weight loss.
In the US, Mounjaro is used for diabetes treatment. Another version of tirzepatide, sold under the brand name Zepbound, is used for weight loss treatment. Zepbound is not licensed as a weight loss product in the UK.
Tirzepatide works for weight loss by mimicking hormones in the body that tell our brain we feel full. A weekly injection is needed, which may be increased in strength each month, depending on the patient.
Clinical studies have found tirzepatide is even more effective than semaglutide (Ozempic and Wegovy) for weight loss. In some studies, patients have lost up to 20% of their body weight.
Supporting weight loss
Until now, Wegovy was the only weight loss injection authorised for NHS use under the care of specialised weight loss services. These services offer patients clinical treatment, mental health support, access to a dietitian and physiotherapy.
But the availability of such services is patchy and recently access to many local services has even been paused or stopped. This means many patients who need effective weight loss treatments may not have access to them. Among the reasons for these services being suspended is there was greater demand than availability of services in some areas, as well as attempts to control prescriptions of crucial drugs due to ongoing shortages.
Initially, it was thought that Mounjaro, would not need to be prescribed by specialists, but Nice have confirmed it will only be prescribed with specialist weight loss services to maximise its benefits and prevent complications.
Now that Mounjaro has been authorised for use on the NHS, it will be key that access to specialist weight loss services is improved throughout the country so that people who need weight loss support are able to get it. NHS England are in the process of developing a range of community and digital services to address this.
Is there enough Mounjaro for everyone?
The change in guidance may lead to a rush in demand for referrals to weight loss services when the drug becomes available. This could add more pressure to an already challenged system.
This uptick in demand may also affect access to Mounjaro for patients who use the drug for diabetes. This was the case with Ozempic (semaglutide) in 2023 - despite it only being licensed for the treatment of diabetes. Demand for the drug by those who wanted to use it to lose weight led to a surge in private prescribing of the drug off-label - leading to global stock shortages of semaglutide.
Many patients using the semaglutide for diabetes were unable to source the product. Semaglutide's manufacturers did not foresee this hike in demand and were not prepared to maintain supplies for people with diabetes.
Since it was introduced on the market, Mounjaro has proved to be a popular product, with sales making its manufacturer, Eli Lilly, greater profits than expected. Stock shortages have already been experienced in Australia and the US. Due to ongoing demand and previous shortages of similar products (such as semaglutide) one would hope that Eli Lilly has anticipated increased demand for Mounjaro in the UK and will have adequate supplies from the outset.
But with British pharmacies reportedly planning to reduce the private price of weight loss products (including Wegovy and Mounjaro), this could increase demand further - which may subsequently affect the availability of supplies for NHS patients.
Given the successes of semaglutide and tirzepatide, it's expected that further similar drugs will be developed. Many of these alternative products are already showing promise in clinical trials - such as an oral weight loss pill. Having alternative products available will ease strain on the supplies of current weight loss products.
Will Mounjaro help with the obesity crisis?
It's thought that up to 25% of adults in the UK are obese. Obesity is linked to many health problems - including heart disease, diabetes and arthritis. Obesity-related healthcare is estimated to cost the NHS billions of pounds every year. Improvements in diet and lifestyle are recommended to tackle obesity, but, understandably, many patients find sustained change difficult.
Greater access to weight loss drugs could help patients lose weight and prevent the associated health problems. This could also save the NHS money and improve long-term health. Weight loss drugs, such as Mounjaro, could be an important solution to a growing problem - but only if access to these treatments is available to those who need them most.
The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
