NHS leaders consider phased roll out of obesity jab to combat high demand

Health officials in England are considering a staggered roll out of an obesity drug due to high levels of demand.

Nearly a quarter of a million people are expected to receive the Mounjaro jab over the next three years, officials said.

NHS leaders have proposed that people who will get the “greatest clinical benefit” should be first in line, which is to be offered with a “wraparound package” including diet and exercise support.

Officials have proposed that Mounjaro, also known as tirzepatide, is first given to people with severe obesity – those with a body mass index score over 40 – who have at least three health conditions linked to weight such as heart disease, high blood pressure or obstructive sleep apnoea.

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The drug would then be offered to those with a BMI of more than 40 plus two weight-related health problems and then to people with a BMI score of more than 40 plus one weight-related health problem.

As well as plans to phase the roll out, health leaders are also considering new ways to deliver the drug as quickly as possible such as digital and community services.

A consultation on the proposals has been launched, which will be considered by the National Institute for Health and Care Excellence (Nice) before it publishes its final guidance on Mounjaro and obesity later this year.

Mounjaro, which is made by Eli Lilly, is a glucagon-like peptide-1 (GLP-1) agonist, a family of medications that help manage blood sugar.

Other GLP-1 agonists include semaglutide – sold under the brand names Wegovy, Ozempic and Rybelsus.

These medicines have seen a number of supply issues in recent months.

People who took the drug in clinical trials, along with support to make changes to exercise and diet, lost an average of 21% of their bodyweight over a 36-week period.

Mounjaro was initially approved as a treatment option for people with type 2 diabetes who cannot tolerate metformin.

And earlier this year, draft guidance from Nice recommended the drug – which costs £122 per month – as an option to help people manage obesity.

Dr Sam Roberts, chief executive of Nice, said: “This new generation of weight loss medications has the potential to achieve important health and wellbeing benefits for people living with obesity. They can also prevent serious health problems from developing, reducing the long-term risks to individuals.

“Our independent committee found this medicine to be both effective and good value for money. Its use will help people living with obesity to lose weight, and as a result substantially reduce the risk that they will develop serious health-related problems associated with obesity such as heart disease and stroke.

“Because of the very large number of people who could potentially benefit, Nice accepts that a phased roll out is required. However, we now need to hear from stakeholders on the proposals we have received from NHS England.”

NHS England’s national medical director, Professor Sir Stephen Powis, added: “This drug 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 roll out will ensure those with the greatest clinical need can access it as a priority – with a quarter of a million people able to benefit over the first three years – while we develop new and innovative services through which other weight loss treatments can also be delivered.

“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 latest Health Survey for England, published last week, found that rates of obesity have not fallen since 2019.

In 2022, some 29% of adults in England were obese while 64% were deemed to be overweight or living with obesity.