An update on weight loss medication, tirzepatide

On 23 December 2024 the National Institute for Health and Care Excellence (NICE) published the Technology Appraisal in relation to tirzepatide (Mounjaro™) which is a new drug for managing obesity.

This medication  is now available in Bedfordshire, Luton and Milton Keynes for certain groups of people with higher levels of obesity and at least four co-morbidities (other conditions). The medication is currently only available through our specialist weight management clinics, as we work through a process and undertake clinical steps before for this is available for patients on prescription.

In the short term this medication will not be available from GP practices, NICE have indicated in the guidance that it could take up to 12 years to make it fully available to the eligible population.

Please see the FAQs below, which provide more information on what this means for Bedfordshire, Luton and Milton Keynes residents.

What is changing in the management of obesity because of NICE’s announcement?

Tirzepatide is currently prescribed for the treatment of type 2 diabetes but  is now available for weight loss purposes but only as described above.

People in England over the age of 18 who are living with obesity and another weight-related health issues will be able to access the weight loss drug tirzepatide through specialist weight management services from spring 2025, if they fit the eligibility cohort

Who can access tirzepatide?

Eventually this medication will be available for people living with obesity who have a body mass index (BMI) of 40 or over and four other weight-related health problems; or a BMI of 37.5 and one weight related health problem; for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, who are at a higher risk of medical problems at a lower BMI.    

Can I access tirzepatide straight away?

Introducing this new treatment to NICE’s estimated 3.4 million eligible patients requires the NHS in England to develop a completely new service for primary care and many healthcare professionals will need to be trained to deliver it. 

A staged approach will help manage demand on existing healthcare services. This allows the safe prescribing of tirzepatide and the appropriate support for patients.

tirzepatide will initially be offered to individuals facing the most significant health risks related to their weight,  through specialist weight management services.

Tirzepatide will not immediately be available and will not be accessible to everyone who wishes to use it.  Initially, tirzepatide will only be available on the NHS to those expected to benefit the most.

How does tirzepatide work for weight loss?

Tirzepatide works by supressing appetite centres in the brain that control gut hormones. It decreases the appetite and slows the movement of food passing through the body, making you feel fuller for longer.

Clinical trials have shown tirzepatide can help people living with obesity lose up 20% of their starting body weight, depending on the dose and accompanying diet and lifestyle support.

Tirzepatide can only be prescribed by a healthcare professional alongside programmes which support people to lose weight and live healthier lives by making changes to their diet and physical activity.

Tirzepatide comes as an injection, which can be self-administered once a week.

What if a patient is already receiving tirzepatide treatment?

Patients can continue taking tirzepatide if they are prescribed it to manage their diabetes.

If patients are using tirzepatide they have acquired privately, they may be able to access the medication through an NHS prescription if they meet the NICE and NHS qualifying criteria. However, patients should not gain advantage over other patients waiting for NHS care.  More information about this will be made available in the new year.

Will everyone who is eligible have access to the drug?

Tirzepatide might not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss. A healthcare professional will discuss the most appropriate care and support, based on individual patient’s need. This could include behavioural support programmes, medical options including prescribing or bariatric surgery.

The NICE announcement mentions ‘wraparound’ care. What does this mean?

Any patient prescribed tirzepatide must participate in the specifically designed ‘wraparound’ care required by NICE guidance. This focuses on diet, nutrition and increasing physical activity. As NHS England develops the service, it will provide more details of the wraparound support offer for patients who qualify.  Patients cannot be prescribed tirzepatide if they do not wish to undertake the wraparound care support.

Will there be a cost to the patient for being prescribed tirzepatide?

Normal prescription charges will apply unless you are entitled to free NHS prescriptions (for example, because you have a medical exemption certificate).