Tirzepatide (Mounjaro®) will initially be offered to individuals facing the most significant health risks related to their weight, starting in March 2025 through specialist weight management services. People who are prioritised for eligibility for Tirzepatide (Mounjaro®) through primary care services should expect to start to get access from June 2025 but this will be defined by cohorts, organised according to the greatest need.

The weight loss drug tirzepatide, also known as Mounjaro®, is a GLP-1 agonist and GIP agonist. Other medications such as semaglutide (Wegovy®), liraglutide (Saxenda®), are known as GLP-1 agonists. They mimic gut hormones released by the body after eating, telling the brain you are full; they also slow down the time it takes the stomach to empty.

Until now, most of these drugs have been used in the NHS to treat diabetes, to help control blood sugar levels as well as encouraging weight loss, helping improve diabetes and other health conditions.

Tirzepatide (Mounjaro®) can only be prescribed by a healthcare professional alongside programmes that support people to lose weight and live healthier lives by making changes to their diet and physical activity. Tirzepatide (Mounjaro®) is an injection, which you inject yourself once a week.

Following June 2025, the cohorts of patients set out below will be eligible for access to Tirzepatide (Mounjaro®) in the first 3 years of delivery. There will be a phased approach to service rollout within primary care and, initially, Tirzepatide (Mounjaro®) will only be available on the NHS to those with the highest clinical need.

This approach will ensure the service is delivered safely and that the NHS in England is able to plan for an increase in the numbers of people eligible for assessment for Tirzepatide (Mounjaro®), whilst building skills and knowledge within the workforce. The National Institute for Health and Care Excellence (NICE) will complete a review at 3 years about who else will be able to access the medication. After that, more information will be provided about the next groups of people.

Access to the medication will be prioritised to ensure patients with the greatest clinical need can access it. This approach was developed based on discussions with clinical experts and engagement with key organisations. The following weight-related health conditions will be used to define the first eligible cohorts:

• type 2 diabetes mellitus
• high blood pressure
• heart disease
• obstructive sleep apnoea (when your breathing stops and starts while you sleep)
• abnormal blood fats (dyslipidaemia)

The different cohorts are:

• Cohort 1: at least 4 of the 5 health conditions listed above plus a BMI of at least 40 (BMI to be adjusted for ethnicity). This cohort will start in June 2025.
• Cohort 2: at least 4 of the 5 health conditions listed above plus a BMI of 35 to 39.9 (BMI to be adjusted for ethnicity). This cohort will have access in year 2.
• Cohort 3: at least 3 of the 5 health conditions and a BMI of at least 40 (BMI to be adjusted for ethnicity*). This cohort will have access in year 3.
  

*Due to an increased risk of heath conditions at lower BMI thresholds in the following populations, the BMI used to assess eligibility for Tirzepatide (Mounjaro®) will be 2.5 kg/m2 lower for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.

Tirzepatide (Mounjaro®) might not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss. There are other options available including weight loss programmes that use tried and tested methods such as lifestyle and behavioural changes, nutrition and physical activity advice. Contact Thriving Nottingham if you live in Nottingham City or Your Health Your Way if you live in Nottinghamshire for free access to expert weight loss and exercise programmes.

Some options depend on the health related conditions you have and your BMI. The NHS Digital Weight Management Programme is available for those with diabetes, high blood pressure (or both) and who have a BMI greater than 30. The BMI threshold is lowered to 27.5 for those from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds. NHS staff do not need high blood pressure or type 2 diabetes to access this programme.

The NHS Type 2 Diabetes Path to Remission Programme is available if you are aged 18 to 65, have a diagnosis of type 2 diabetes within the last 6 years and have a BMI over 27 kg/m2 (for people from White ethnic groups) or over 25 kg/m2 (for people from Black, Asian and other ethnic groups).

Adults can access the NHS Diabetes Prevention Programme if they have had a blood test in the last year that shows they are at risk of diabetes.

Every patient prescribed Tirzepatide (Mounjaro®) on the NHS is required to participate in a specifically designed ‘wrap-around’ care service, as stipulated under NICE guidance. This focuses on diet, nutrition and increasing physical activity. Patients cannot be prescribed Tirzepatide (Mounjaro®) if they do not wish to get the wrap-around care support