A new weight-loss medication, Mounjaro, will soon be available on the NHS in England, though a slow rollout means it could take up to 12 years for all eligible patients to receive it, according to the NHS drugs advisory body.
The National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending the medication, which helps patients feel fuller and eat less, be introduced in March 2024. Initially, Mounjaro will be available to people with a body mass index (BMI) over 35 who also have at least one obesity-related health condition, such as type 2 diabetes or high blood pressure, potentially affecting around 3.4 million individuals.
However, due to concerns about overwhelming NHS services, particularly general practitioners (GPs), NICE has decided to implement a phased approach to its rollout, which will span over a decade. This move marks an unprecedented step for a new medication.
A Slow Rollout Plan
Initially, Mounjaro will be offered only to patients under specialist weight-management care, similar to the approach used for the weight-loss drug Wegovy. The drug will be available more widely from June 2024, although the details of how this will happen are still unclear. GP practices are likely to handle patient referrals, but there are uncertainties regarding how ongoing support, including diet and exercise guidance, will be provided. NHS England is expected to release more guidance on this in the new year.
Mounjaro, manufactured by Eli Lilly, has shown promising results in trials, with patients losing up to 20% of their body weight. It works by suppressing appetite, helping individuals eat less. In the U.S., it has been approved for use in type 2 diabetes patients but is now being extended to those struggling with obesity in the UK.
Widespread Interest, But Concerns Over Delays
The decision to delay full access has drawn criticism from patient groups. Helen Kirrane of Diabetes UK expressed concern about the long wait for some people to receive the drug. However, NICE emphasized the importance of a controlled rollout to protect other NHS services.
Dr. Kath McCullough, NHS England’s national obesity adviser, defended the phased approach, acknowledging the growing public health issue of obesity while emphasizing the need to maintain access to other essential NHS services.
While Mounjaro will cost the NHS £122 per patient per month for the maximum dose, NICE deemed it cost-effective due to the high costs associated with obesity-related conditions. However, there are concerns that patients may regain weight after stopping the treatment.
Looking Ahead
The initial rollout of Mounjaro is expected to benefit around 220,000 individuals within the first three years. NICE will evaluate the progress before expanding the rollout further. If there are no appeals against the decision, the guidance will be finalized before Christmas.
The drug will also be available in Wales and Scotland, although reports suggest challenges with its rollout in Scotland. Mounjaro’s availability marks a significant step in providing a new option for people with severe obesity, but the long wait for full access is raising concerns among both healthcare professionals and patients alike.