A new weight-loss injection, Mounjaro, is set to be rolled out across the NHS in England. However, according to the NHS drugs advisory body, the process may take up to 12 years before everyone eligible receives it. The National Institute for Health and Care Excellence (NICE) has issued a final draft of guidance recommending that the jab be made available starting in March, alongside a focus on diet and exercise. The new jab will primarily be offered to people with a body mass index (BMI) of over 35 who also suffer from at least one obesity-related health condition, such as diabetes, high blood pressure, or heart disease. This is expected to impact around 3.4 million people in England.
Why Is the Rollout Being Phased to Protect NHS Services?
Despite the potential benefits for those struggling with obesity, concerns have been raised about the pressure the drug’s rollout could place on the NHS. Specifically, the NHS could be overwhelmed, especially in primary care settings such as GP practices. As a result, NICE has decided to take an unprecedented step, allowing the NHS more than a decade to implement the program entirely. NICE’s chief medical officer acknowledged that many people would have to wait for access to Mounjaro. “We’ve had to make this difficult decision to protect vital NHS services and also to test ways of delivering this new generation of weight-loss medications,” said the chief medical officer.
While some patient groups have expressed disappointment at the long wait, others understand the reasoning behind the decision. The phased approach will allow the NHS to manage its resources carefully and ensure the new treatment is introduced without disrupting other crucial services.
Who Will Be Eligible for Mounjaro in the Initial Rollout?
At first, Mounjaro will only be available to patients under specialist weight-management services, which aligns with the rollout of a similar drug, Wegovy. This restriction is expected to impact around 40,000 people currently in these services. However, from June onwards, the NHS plans to extend the availability of Mounjaro to a wider group of patients, though the exact mechanism for this broader distribution remains to be determined. GP practices likely play a central role in referring patients. Still, questions remain about who will provide ongoing support for diet, exercise, and monitoring, which are essential for the success of the treatment.
NHS England is expected to provide more details on this process early in the new year, with possibilities including the use of digital health tools, such as apps, or separate services that support GPs in managing patients.
How Do Mounjaro and Wegovy Compare as Weight-Loss Treatments?
Mounjaro, also known as tirzepatide and produced by Eli Lilly, helps people feel fuller for longer, reducing their appetite and leading to weight loss. Mounjaro patients lost around 20% of their body weight in clinical trials. Similarly, Wegovy (semaglutide) works in the same way but is only available to patients under the care of specialist weight-management services. Wegovy has already been rolled out on the NHS, but its availability has been more limited.
Mounjaro and Wegovy are also approved for treating type 2 diabetes, but under different brand names, such as Ozempic for those managing diabetes. The rollout of Mounjaro represents a vital opportunity to provide these effective weight-loss treatments to a broader public, particularly those with severe obesity. To qualify for the drug, patients must also have at least one obesity-related health condition.
How Will Mounjaro Be Rolled Out and Prioritized?
In the first three years of the rollout, the NHS expects approximately 250,000 people to benefit from Mounjaro. The aim is initially to prioritize patients with the highest clinical need. NICE will then review the progress of the rollout before making decisions about further expansion.
As the rollout is based on final draft guidance, there is still a possibility that delays could occur if appeals are made against the decision. However, if there are no challenges, the guidance is expected to be formally approved before Christmas, which would trigger the phased introduction of the drug. Mounjaro, given as a weekly injection, will cost the NHS £122 per patient per month. NICE has deemed this cost justifiable, considering the long-term cost savings associated with treating obesity-related conditions.
What are the risks of using Mounjaro and the possibility of weight Gain?
While Mounjaro offers significant weight-loss potential, it is not without risks. One concern is that patients may regain the weight after they stop using the drug. This underscores the importance of combining Mounjaro with long-term lifestyle changes, including diet and exercise, to achieve sustained weight loss. A national speciality adviser for obesity emphasized that weight-loss medications like Mounjaro are essential in addressing one of the NHS’s most significant public health challenges. However, she cautioned that a phased rollout is necessary to ensure that other NHS services are not compromised.
What Are the Reactions to the Timeline for Accessing Mounjaro?
The introduction of Mounjaro has garnered both support and concern from various stakeholders. Diabetes UK acknowledged the “significant” role Mounjaro could play in tackling obesity but expressed concern over the extended timeline for patient access. “We have concerns over the length of time it might take for people to gain access,” a representative said.
On the other hand, a spokesperson from the Royal College of GPs warned that the drug should not be seen as a “silver bullet” for obesity. He pointed out that the treatment may only be suitable for some eligible and carries potential risks. As with any new treatment, there will need to be careful consideration of who will benefit the most from Mounjaro and how to provide ongoing support for those using it.
What Does the Future Hold for the Rollout of Mounjaro?
As the NHS prepares to launch Mounjaro in March, the drug’s wider rollout is still a few years off. NICE’s decision to allow a slow, staged introduction ensures that the health service can manage demand without overwhelming its resources. For many, however, the wait will be frustrating as they face a prolonged period before being able to access a potentially life-changing treatment. As NHS guidance on how GPs will manage the rollout is finalized, patients will have to remain patient as the details of the process unfold.
