Is Mounjaro Available on the NHS?

Recently, so-called ‘skinny jabs’ have had a lot of attention in the media, with Wegovy reaching the UK market this year. Now, there is a new range of drugs being developed that build on the success of Wegovy and Saxenda. These drugs target multiple pathways to help you lose weight. The latest of these drugs to hit the UK market is Mounjaro. 

Currently only available as a diabetes treatment on the NHS, Mounjaro has shown great success as a weight loss medication and has recently become privately available for weight loss. If you are interested in trying Mounjaro, you can begin an assessment to receive this medication from Simple Online Pharmacy.

What is Mounjaro?

Mounjaro (tirzepatide) is a diabetes medication that helps people control their blood glucose levels, but clinical trials have shown that it is also an effective weight loss drug. Saxenda and Wegovy are similar drugs known as GLP-1 inhibitors or incretin mimetics. They work by slowing down the emptying of the stomach, which helps to decrease appetite.

Mounjaro works this way too, but also acts on the glucose-dependent insulinotropic polypeptide (GIP) receptors in your brain, further reducing your appetite. Mounjaro is a dual-action drug because it exploits two different pathways in the body to help you lose weight.

Mounjaro is a weekly injection given in the abdomen, thigh or upper arm. It comes in a pen injector, so you can administer the medication at home yourself. When you start taking Mounjaro, you start on the lowest dose and increase it slowly over several weeks to reduce the risk of side effects.

The side effects of Mounjaro can include tiredness, nausea, vomiting, abdominal pain, hypoglycemia (low blood sugar), diarrhoea and constipation. Some patients also experience an allergic reaction to Mounjaro. In rare cases, people on Mounjaro have experienced gallstones and problems with their pancreas.

Mounjaro is not suitable for all patients; those with a history of multiple endocrine neoplasia syndrome type 2 (MEN 2), or a history of medullary thyroid cancer (MTC) should not use this product, as it may increase your risk of recurrence.

For Mounjaro, the UK NHS have approved its use for the treatment of type 2 diabetes, but it is not currently available for weight loss purposes. As with all medications that come to the NHS, this decision was made by the National Institute for Health and Care Excellence (NICE). However, as of February 2024, Mounjaro is now available for private prescription for weight loss.

NHS Weight Loss Services

There are four tiers of weight management services on the NHS. The first point of contact is your GP. Typically, they will begin with a discussion about your weight before offering lifestyle advice about diet and exercise as well as any behavioural strategies that may support your weight loss journey.

If you do not achieve sufficient results with these methods, your GP can refer you to other services with more specialised experience in weight management. This could involve having an appointment with a specialist nurse or a dietician or participating in a community group. In this tier (tier 2), you will receive more personalised information about nutrition, lifestyle and behaviour modification.

Having tried tiers 1 and 2, your GP may be able to refer you to tier 3 services. This will give you access to a more specialist weight management clinic. These clinics are supported by a multidisciplinary team including psychologists, physiotherapists and doctors. The team will work with you to identify the best approach to your weight loss and medications such as Wegovy, may be prescribed at this point. 

Tier 4 is the highest level weight loss service available on the NHS. This is reserved for people with significant weight management issues who have not responded sufficiently to other treatment approaches. These services offer more invasive procedures such as a gastric balloon or gastric sleeve surgery. These procedures can be highly effective, but they do carry greater risk than other interventions, so your team will discuss the risks and benefits with you carefully before you make any final decisions.

NHS GLP-1s

Saxenda and Wegovy are both available on the NHS for people losing weight. Due to the expense of the treatment, they are currently only offered through Tier 3 Weight Management Services. This means that you will have had to try various other weight loss methods, including diet and exercising, before you will be allowed to try these drugs.

Saxenda and Wegovy both belong to a class of drugs called GLP-1 inhibitors. They work by slowing the emptying of your stomach when you eat. This helps you to feel fuller for longer which reduces your appetite, helping you to eat less. Common side effects include fatigue, dizziness, headache and other gastrointestinal side effects including constipation, diarrhoea, abdominal pain, nausea and vomiting.

It is also important to recognise that these drugs are only approved for use in certain patient groups. Specifically, Wegovy and Saxenda are intended to be used by people with a BMI of 30 or above, or by people with a BMI of 27 or above, if they also have a weight-related medication condition like high blood pressure. You can check your BMI with an online calculator.

If your BMI is high enough, and you wish to try Saxenda or Wegovy on the NHS, speak to your GP who can start to refer you to the various weight management services available in your area. It is important to recognise that due to limited resources, your GP cannot prescribe you these medications themself and it may take some time before you’re able to receive these medications from the appropriate Tier 3 service.

Will Mounjaro be Available on the NHS?

In November 2023, Mounjaro was authorised by the MHRA (Medicines and Healthcare Products Regulatory Agency) for use in weight loss in the UK. However, Mounjaro has not yet been approved for weight loss by NICE (National Institute for Health and Care Excellence). This means that, despite the authorisation of Mounjaro, NHS services will be unable to prescribe Mounjaro for weight loss at this time.

In September 2023, NICE approved Mounjaro as a treatment option for people with type-2 diabetes, but they did not approve it for weight loss as they are awaiting more evidence. NICE weighs up multiple factors when making these decisions such as the benefits of the treatment, the availability of alternatives and the cost effectiveness. 

NICE are expected to make their decision about Mounjaro in March 2024, until then, we will not know for certain if Mounjaro will be available on the NHS for weight loss. Despite this, it is less likely that Mounjaro will be approved for weight loss on the NHS, because Wegovy is already available and is likely to be cheaper than Mounjaro, so the costs are unlikely to be seen to outweigh the benefits at this time.

If Mounjaro is ever made available on the NHS as a weight loss treatment, it is likely that it will be under the same restrictions as Wegovy. Currently, Wegovy is only available to people with a body mass index (BMI) of 30 or more, or a BMI of 27 or more if they also have a weight-related health problem like high blood pressure. 

People who meet these criteria are only able to access the drug through a tier 3 weight management service, which means they will have had to try many other weight loss treatments before they will be offered the drug on the NHS.

Alternatives on the NHS

It can take a long time to receive GLP-1 drugs on the NHS for weight loss, so it is a good idea to consider other options. Your GP is the first point of contact.

They can give you basic lifestyle advice, look at potential causes for being overweight and prescribe some weight loss medications, such as orlistat. Orlistat is a tablet commonly referred to as a fat-binder. It helps to stop you digesting fat, which means that you do not absorb it into your body.

After discussing your weight with your GP, they may suggest a referral to other services which specialise in weight management. This may include appointments with a dietician, a specialist nurse or a community group, who can provide you with more information about nutrition, lifestyle and ways to modify your long-term behaviours around food.

Once you have tried these options, you may be eligible to be referred to a Tier 3 weight management service. These services provide specialist weight management clinics where you will be supported by a range of different medical professionals. It is here that medications such as Wegovy or Saxenda may be offered. There may also be input from psychologists and physiotherapists at this stage if appropriate.

Tier 4 weight management services are more invasive procedures, and are therefore reserved for people who did not find success through other methods. At this stage, you may be referred to a bariatric surgery team. They may discuss non-surgical procedures, such as a gastric balloon, or more invasive procedures like gastric sleeve surgery.

Private Alternatives

Private services provide many of the same services as the NHS, but are generally not so restricted by limited resources. This means that it can be easier to access weight loss medications, psychologist appointments and surgeries through private providers.

At Simple Online Pharmacy, we offer three different weight loss drugs: Saxenda, Wegovy and orlistat. Orlistat is a tablet, whereas Saxenda and Wegovy are injections.

If you want to try Wegovy or Saxenda, simply visit our Weight Loss Injections page and complete an assessment form. The form will be reviewed by our doctors who will assess whether the treatment is appropriate for you. If suitable, it will be prescribed and dispatched, direct to your door.

Conclusion

Mounjaro is currently available on the NHS as a diabetes treatment only. Currently, you cannot get Mounjaro for weight loss purposes through the NHS and can only receive it through private prescription. Although, the NHS does provide alternative treatments such as Saxenda, Wegovy, and guidance on lifestyle changes you can make to help manage your weight.

Summary

• You can get Mounjaro on the NHS for treating diabetes; currently, it is only available for weight loss in the UK through private prescription.
• Mounjaro side effects may include tiredness, nausea, vomiting, abdominal pain, hypoglycemia (low blood sugar), diarrhoea and constipation
• Mounjaro is a dual action GLP-1/GIP receptor medication, meaning it works on two pathways to make losing weight easier
• Currently, GLP-1 medications such as Wegovy are available through the NHS, if you qualify for certain weight loss clinics