England’s National Health Service (NHS) has proposed a phased launch of Eli Lilly’s blockbuster weight loss drug Mounjaro (tirzepatide) because of the large number of patients who could benefit from using it.
The proposal was sent by the NHS to the National Institute for Health and Care Excellence (Nice) as the regulator decides how to distribute the treatment. The regulator recommended Mounjaro for those who are obese in June this year. The weekly injection costs £122 per month at its maximum dose of 15g.
NICE’s chief executive Dr Sam Roberts said: “Because of the very large number of people who could potentially benefit, NICE accepts that a phased rollout is required.”
NICE has now opened a consultation period of three weeks to decide exactly how the rollout will work before publishing final guidance later this year, as per a 3 October press release.
Mounjaro has made waves in the weight loss space due to its high efficacy, helping improve patient outcomes far more than diet and exercise alone. As a result, demand for the injection exceeded supply during initial launches in the US and UK. These shortages lasted nearly two years but yesterday (3 October) it was removed from the US Food and Drug Administration’s (FDA’s) drug shortage list.
Mounjaro’s biggest competitor in the weight loss ring is Novo Nordisk’s Wegovy (semaglutide) which received approval to be used in the NHS in September 2023.
Mounjaro, which was authorised for obesity treatment in England in November 2023, works by regulating patients’ appetite, making them less hungry and reducing food cravings. Eli Lilly markets tirzepatide for weight loss as Zepbound in the US, whereas in the UK Mounjaro is used for both weight loss and type 2 diabetes treatment, having won clearance for the latter indication in September 2023.
Amid unprecedented demand for Eli Lilly’s injection, the NHS proposes that those with a body mass index of more than 40 kg/m2 who also have at least three comorbidities of hypertension, dyslipidaemia, obstructive sleep apnoea, or cardiovascular disease will be first in line as part of the initial rollout. Those who have the same BMI but only live with two weight-related problems would be offered Mounjaro next, with those who have a solitary weight-related issue last.
Mounjaro would be part of a wraparound package including diet and exercise, with a multidisciplinary team (MDT) of healthcare professionals providing patient support. NICE stated that various community-based services and digital technologies are being developed to deliver the injection to nearly 250,000 people during the first three years of rollout.
Obesity rates in England have been increasing over the past decade, with the cost of treating conditions associated with disease placing a financial burden on the NHS amounting to £11.4bn per year, as per a 2023 report. Around 64% of adults are either overweight or living with obesity in the country.
NHS national medical director Professor Sir Stephen Powis said: “[Mounjaro] will be a powerful part of our arsenal to tackle obesity and support many more people to lose weight and reduce their risk of diabetes, heart attack and stroke, and this phased rollout will ensure those with the greatest clinical need can access it as a priority.”
Global sales of Mounjaro and Zepbound have skyrocketed, leading Eli Lilly to raise its revenue guidance for 2024 off the back of strong early sales. Mounjaro generated global sales of $5.2bn in 2023, with revenue forecast to reach $32.4bn by 2030, according to analysis by GlobalData.
GlobalData is the parent company of Pharmaceutical Technology.
