Fewer than 10 per cent of patients in England who are eligible for what has been dubbed the “King Kong of weight loss drugs” will initially be able to access it on the health service.
Health officials revealed on Thursday they are prioritising the drug for people with the highest needs.
The “difficult decision” was made “in order to protect other vital NHS services”, the National Institute for Health and Care Excellence (Nice) said.
The NHS spending watchdog has recommended Mounjaro – also known as tirzepatide and made by Eli Lilly – for those with a body mass index (BMI) of more than 35 and at least one weight-related illness.
This is estimated to account for about 3.4 million people.
To help the NHS manage demand, Nice said about 220,000 people could benefit from the drug in an initial three-year period. After this, the situation will be reviewed by Nice, who will provide further guidance on the rollout.
Mounjaro is a glucagon-like peptide-1 (GLP-1) agonist, a family of medications that help manage blood sugar.
It was initially given the green light to help manage obesity on the NHS in June as part of draft guidance from Nice.
The once-weekly jab should be prescribed alongside a reduced-calorie diet and exercise to help people lose weight.
Other GLP-1 agonists include semaglutide – sold under the brand names Wegovy, Ozempic and Rybelsus.
Professor Jonathan Benger, chief medical officer at Nice, said: “Tirzepatide and other drugs like it, such as semaglutide, will help people living with obesity to lose weight, and as a result will reduce their risk of developing heart disease or having a stroke.
“But tirzepatide is not for everybody, and only those with the highest clinical need will be treated initially.
“This means many people will have to wait. We have had to make this difficult decision in order to protect other vital NHS services and also to test ways of delivering this new generation of weight loss medications.”
Final draft guidance published by Nice shows NHS England requested that Mounjaro is rolled out over 12 years.
The watchdog recommends prioritising patients receiving care from specialist weight management services who will be able to access the drug within 90 days of the guidance being published on December 23.
The latest Health Survey for England shows 64 per cent of adults were overweight or obese in 2022.
However, Dr Kath McCullough, NHS England’s national speciality adviser for obesity, warned that weight loss jabs “are not a magic bullet”.
She said: “On their own, weight loss drugs are not a magic bullet. They need to be prescribed by a healthcare professional alongside programmes that help people lose weight and live healthier lives by making changes to their diet and physical activity – and it’s also crucial that they are prioritised for those who need them most.”
It comes as a trial by Mounjaro manufacturer Eli Lilly – known as Surmount-5 – found patients on tirzepatide recorded a weight loss of 20.2 per cent compared to 13.7 per cent in patients on semaglutide.
