As officials consider how to distribute Eli Lilly’s Mounjaro to a nation that has a rapidly growing (PDF) obesity problem, England’s National Health Service (NHS) is proposing that those who need it most should get it first.
Over the next three years, Britain aims to provide Mounjaro to 250,000 patients on NHS. In a request to the National Institute for Health and Care Excellence (NICE), the NHS outlined a strategy to combine the use of community clinics and online services to phase in the launch of the weight-loss drug.
NICE has opened a consultation period of three weeks before publishing guidance on how the rollout will work.
“Because of the very large number of people who could potentially benefit, NICE accepts that a phased roll out is required," Sam Roberts, NICE’s chief executive, said in a release. "However, we now need to hear from stakeholders on the proposals we have received from NHS England."
In June, NICE recommended that Mounjaro be provided to those who are obese, with a maximum weekly dose of 15 mg costing £122 ($160) per month.
The NHS now proposes that those who are the most obese—with a BMI of at least 40—and who have at least three weight-related disorders be first in line. The potential health issues include hypertension, type 2 diabetes, sleep apnea and cardiovascular disease. Next in line would be those with a BMI of 40 or more and with two weight-related health problems, then those with one.
The medicine would be the key part of a package that would include diet and exercise support. Supporting patients though their treatment would be a multidisciplinary team including a dietitian, a psychologist and an exercise instructor.
Included in the NHS’s proposal is a plan to provide the multidisciplinary support services online, as well.
“This phased rollout will ensure those with the greatest clinical need can access it as a priority—with a quarter of a million people able to benefit over the first three years—while we develop new and innovative services through which other weight loss treatments can also be delivered,” Sir Stephen Powis, the NHS' national medical director, said in the release.
While Mounjaro was cleared for use in England last year, Lilly put its launch on hold until its pre-filled injection device, Kwikpen, was endorsed in January by the Medicines & Healthcare products Regulatory Agency (MHRA). The product was cleared for both type 2 diabetes and obesity patients.
In February, Superdrug and Simple Online Pharmacy were the first companies to provide Mounjaro to patients at a monthly cost of £215 ($270) and £185 ($243). England was the fourth country in Europe to launch Mounjaro after Germany, Switzerland and Poland.
Lilly reported worldwide sales of Mounjaro, which was approved by the FDA in 2022, at $5.2 billion in 2023. Analysts project its sales will rise sharply through the rest of the decade.