Indication

Overweight and Obesity

RAG rating

Double Red

Document type

n/a

Place

Hertfordshire and West Essex ICB

Output type

Pharmacy / Prescribing

Tirzepatide for obesity

 

Tirzepatide (Mounjaro^®) for managing obesity

On 23 December 2024, the National Institute for Health and Care Excellence (NICE) are expected to publish their final recommendation on the use of tirzepatide (Mounjaro®) for managing obesity. NICE will recommend tirzepatide, alongside "wrap around” care, for a considerable proportion of the population living with obesity, in settings including primary care.  However, due to the significant impact this will have on primary care and NHS budget, NICE have approved NHS England’s funding variation request for a phased roll out over 12 years. 

Tirzepatide will initially be offered through specialist weight management services (SWMS). This is expected to start from spring 2025.

The phased roll out will start with individuals facing the most significant health risks related to their weight. NHS England is currently engaging with relevant clinical and professional bodies to establish which patients will be eligible first.

Patients who will be eligible for weight loss medication must also participate in specifically designed ‘wraparound’ care. This focuses on diet, nutrition and increasing physical activity. While national specifications and local plans for the introduction of tirzepatide and the required ‘wraparound care’ are developed, it is not recommended for primary care prescribing. A new model of care for offering tirzepatide and ‘wraparound care’ outside of SWMS, should be in place from summer 2025.

Semaglutide (Wegovy®) and liraglutide (Saxenda®) are alternative treatments for managing obesity (weight-loss) which are also not recommended for primary care prescribing.

Glucagon-like peptide-1 (GLP-1) receptor agonists should not be prescribed in primary care for weight loss. 

Further information for patients including self-help resources and services available locally are available at the link below. Hertfordshire and West Essex (HWE) ICB is urgently reviewing local access to GLP-1 receptor agonists in SWMS (Tier 3). In the meantime, to avoid delay in patients receiving treatment for obesity, please continue to refer into the local commissioned specialist weight management (tier 3) services. These are TBC Healthcare in Herts and Morelife in West Essex. Many patients may be interested in referrals under patient choice to Oviva, a consultant-led service.  However, the ICB commissions non consultant-led tier 3 services with Morelife (West Essex place) and TBC Healthcare (EN & SW Hertfordshire place) and this is the correct route for referrals. The ICB is drafting a clinical policy on referrals to consultant-led specialist weight-management services.  Patients should be advised that even if they meet the NICE criteria, GLP-1s may not be the most clinically appropriate option for them. The clinical teams within the SWMS will determine suitability as part of the patient’s management plan.

To help support with queries, information on weight loss injections for patients has been added to the HWE ICS website  Weight loss injections - Herts and West Essex ICS  This website explains to patients that GPs cannot currently prescribe GLP-1s for obesity. It also provides information on the range of services available to support people to lose weight, including how to self-refer.