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Tirzepatide (Mounjaro): weight loss
This information aims to provide information relating to
tirzepatide (Mounjaro) as it is released from NHSE and in line with local
implementation plans.
Introduction
Tirzepatide (Mounjaro) is a weight loss drug that, up to
now, has only been prescribed for people with type 2 diabetes.
NICE published guidance on 23 December 2024 recommending that tripeptide (Mounjaro) be considered a treatment option for managing overweight and obesity, alongside a reduced-calorie diet and increased
physical activity.
Tirzepatide (Mounjaro) criteria
Initially, because of the impact on services, NICE agreed
that NHS England should publish criteria for the priority cohorts for
Tirzepatide (Mounjaro).
Those priority cohorts are:
|
Year
|
Estimated
Duration
|
Cohort
|
Cohort
description (based on comorbidities)
|
BMI
|
|
1
|
12
months
|
i
|
more than 4 qualifying
comorbidities
|
greater
than 40
|
|
2
|
9
months
|
ii
|
more than 4 qualifying
comorbidities
|
35-39.9
|
|
2/3
|
15
months
|
iii
|
3
qualifying comorbidities
|
greater
than 40
|
The Qualifying Co-morbidities are as follows:
|
Qualifying Co-morbidities
|
Definition
|
|
Atherosclerotic
Cardiovascular Disease (ASCVD)
|
Established
ASCVD (ischaemic heart disease, cerebrovascular disease, peripheral vascular
disease, heart failure)
|
|
Hypertension
|
Established
diagnosis and requiring blood pressure lowering therapy
|
|
Dyslipidaemia
|
Treated
with lipid-lowering therapy, or LDL lower than/equal to 4.1
mmol/L, or HDL lower than 1.0 mmol/L for men or HDL lower than 1.3mmol for
women, or fasting triglycerides lower than/equal to 1.7 mmol/L
|
|
Obstructive
Sleep Apnoea (OSA)
|
Established
diagnosis of OSA (sleep clinic confirmation via sleep study) and treatment
indicated i.e. CPAP or equivalent
|
|
Type 2
diabetes
|
Established
diagnosis
|
Over time, these cohorts will be expanded to include the full
criteria for tirzepatide (Mounjaro) which are:
People over the age of 18 who have a body mass index (BMI)
of 35 or over (or a BMI of 32.5 for people from South Asian, Chinese, other
Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds,
as they are at a higher risk of medical problems at a lower BMI) and one of the
above weight-related co-morbidities.
Weight loss injections are not suitable for patients who:
- Have
previously had weight loss surgery.
- Are
not engaging in NHS wrap-around care.
Please also see the product SmPC for
a complete list of prescribing cautions and contraindications.
Wrap-around care
The NICE TA1026 mandates provision of wrap-around care
alongside the prescribing of tirzepatide (Mounjaro). NHSE expects that this
will incorporate nutritional and dietetic advice as a minimum and access to
behavioural change components, as a mandatory requirement to access treatment.
Further information
BMA: Tirzepatide (Mounjaro) for weight management in General Practice
Private prescribing
NHS
services are currently unable to support patients who buy weight loss
injections and the ICB is not able to advise on a safe place to buy weight
loss injections.
We
are aware that there are private providers who offer Tirzepatide; please
be aware that some people may experience side effects, which may not be
safely monitored by non-NHS providers. The private provider should offer a
wrap-around service to support patients, and we would recommend that
patients engage with this.
Online purchase
The UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) warns
against buying weight loss medicines without a prescription.