The National Institute for Health and Care Excellence is consulting on a phased roll-out of Eli Lilly’s weight loss drug tirzepatide – more commonly known as Mounjaro – as NHS England looks to combat obesity.
The scale of the proposed launch from NHSE is unprecedented, with new community-based and digitally-powered operating models being developed to deliver the injection to almost 250,000 people in the first three years alone.
NHSE wants the patients most likely to achieve the greatest clinical benefit to be prioritised over the roll-out, which could last nearly a decade.
Mounjaro
Tirzepatide was granted approval from the Medicines and Healthcare products Regulatory Agency last November, while NICE recommended the treatment for those living with obesity in draft guidance this summer.
Clinical trial data has found that tirzepatide is more effective than diet and exercise alone, as well as when compared to well-known weight loss alternative semaglutide – otherwise known as Wegovy.
On average, patients lost a fifth (20.9%) of their bodyweight in 36 weeks during the SURMOUNT-4 study. At its maximum 15mg dose list price, tirzepatide costs £122 per month.
Those eligible as part of the proposed roll-out include people with BMIs of over 40 with at least three weight-related health problems. This includes:
- Hypertension
- Dyslipidaemia
- Obstructive sleep apnoea
- Cardiovascular disease
The roll-out will then transition to those with BMIs over 40 who have two weight-related issues and then people with just one problem. Frontier Economics analysis estimates that the cost of treating conditions associated with obesity puts an £11.4bn burden on the NHS every year.
The latest Health Survey for England indicates that approximately two-thirds (64%) of adults are either overweight or living with obesity.
NHS implications
“Because of the very large number of people who could potentially benefit, NICE accepts that a phased roll out is required,” explained NICE’s CEO, Dr Sam Roberts.
She added: “This new generation of weight loss medications has the potential to achieve important health and wellbeing benefits for people living with obesity.”
Multidisciplinary teams comprising dietitians, psychologists, physical activity instructors and others could deliver the medicine in either primary or secondary care settings.
National medical director at NHSE, Professor Sir Stephen Powis, has said tirzepatide will be a “powerful part” the NHS’s arsenal when tackling obesity.
He continued: “With the sheer number of people potentially eligible for these treatments and GP teams already delivering record numbers of appointments, the NHS is developing a range of community-based and digital services to provide the benefits of weight loss drugs while continuing to ensure GPs can deliver all other vital services patients rely on.”
The consultation will be live for three weeks with final NICE guidance for tirzepatide for obesity expected in early December.
Image credit: iStock
