NICE outlines rollout plan for tirzepatide
The National Institute for Health and Care Excellence (NICE) has unveiled its final draft guidance on the rollout of tirzepatide, a weight loss medication set to benefit around 220,000 people living with obesity in England over the next three years.
The plan prioritises those with the highest clinical need, offering the drug alongside a reduced-calorie diet and increased physical activity.
Tirzepatide, also known as Mounjaro®, is recommended for individuals with a body mass index (BMI) over 35 and at least one weight-related illness, such as type 2 diabetes or cardiovascular disease. Due to the large eligible population, estimated at 3.4 million in England, the NHS will implement a phased rollout to manage demand and maintain other essential services.
Patients already enrolled in specialist weight management services will be the first to receive the medication, with access beginning 90 days after NICE’s final guidance is published, provided they meet the clinical criteria. Those with the highest need outside these services will follow six months later. NHS England is developing a plan to identify additional patient groups for the initial three-year phase.
“This unprecedented decision allows us to test new approaches to delivering weight loss medications like tirzepatide while safeguarding other NHS services,” said Professor Jonathan Benger, NICE’s Chief Medical Officer. He emphasised that tirzepatide is not a universal solution and that a phased approach ensures sustainable implementation.
Clinical trials, including the SURMOUNT-4 study, demonstrated that tirzepatide, delivered via weekly self-administered injections, helped patients lose an average of 21% of body weight over 36 weeks when combined with diet and exercise. Despite its cost, £122 per injection, with an estimated £317.2 million annual NHS expenditure by year three, NICE deems the drug a cost-effective intervention due to its potential to reduce obesity-related health complications.
Dr. Kath McCullough, NHS England’s National Specialty Advisor for Obesity, highlighted the broader health benefits of weight loss, stating, “Drugs like tirzepatide not only support weight loss but also lower the risk of serious conditions such as diabetes and heart disease. However, they must be paired with comprehensive support to help patients lead healthier lives.”
NICE plans to reevaluate the rollout after three years to refine the strategy for wider patient access, ensuring safe and effective delivery. New guidelines on managing obesity and overweight are also being introduced, consolidating existing NICE recommendations to aid prevention and treatment.
Patients not eligible for tirzepatide are encouraged to explore weight management resources through NHS Better Health. Obesity remains a pressing public health challenge, with approximately 64 per cent of adults in England classified as overweight or obese, according to the Health Survey for England 2022.
If no appeals are submitted, NICE expects to publish its final guidance on 23 December 2024, with the first patients receiving tirzepatide in early 2025. Further service delivery guidance from NHS England is anticipated next year.