People with a BMI of 35 and a comorbidity may now be prescribed tirzepatide, with NICE asserting its greater effectiveness compared to Wegovy.

The National Institute for Health and Care Excellence (NICE) released draft guidance on Tuesday, recommending that individuals with severe obesity be prescribed tirzepatide, marketed in the UK as Mounjaro.

Mounjaro is a more effective alternative to semaglutide.

Within three months of the final guidance being issued, doctors in England will be able to prescribe Mounjaro to individuals with a body mass index of at least 35 and at least one weight-related comorbidity, such as heart disease, type 2 diabetes, or sleep apnoea.

NICE’s draft guidance states: “Clinical trial evidence suggests that tirzepatide, combined with diet and exercise support, is more effective compared to diet and exercise support alone.

“Indirect comparisons suggest it is more effective compared with semaglutide alongside diet and exercise support.”

Semaglutide, better known as Wegovy, was the first anti-obesity drug approved by NICE in 2022.

Wegovy is manufactured by Novo Nordisk. Mounjaro meanwhile is produced by Eli Lilly.

Experts anticipate that patients will find it easier to obtain Mounjaro, and it is likely to become more widely used than Wegovy, as GPs, rather than just NHS weight management services, will be able to prescribe it.

NICE’s decision is expected to increase the number of individuals taking obesity medication.

Clinical trials have demonstrated that tirzepatide users have lost 22.5% of their body weight over 72 weeks, compared with 16% over 68 weeks with Wegovy.

Dr Nerys Astbury, an associate professor of diet and obesity at Oxford University, commented: “The introduction of more pharmacological options to help healthcare professionals outside specialist weight management settings treat people living with obesity can only be seen as a positive development.”

NICE stated that a four-week supply of pre-filled pens of Mounjaro would cost between £92 and £122, depending on the dose size, but this represents a good use of NHS resources as it would reduce the likelihood of patients developing other serious health complications.

Patients prescribed Mounjaro will be able to continue taking it for as long as necessary, whereas NICE has imposed a two-year limit on the use of Wegovy.

Dr Simon Cork, a senior lecturer in physiology at Anglia Ruskin University, noted that, despite NICE setting a BMI threshold of 35 for the receipt of Mounjaro, meaning “very few patients” will qualify, others will likely seek it as they have done with Wegovy.

Prof Sir Stephen O’Rahilly, a professor of clinical biochemistry and medicine at Cambridge University, stated that, given the increasing rates of dangerous weight gain, “medicines such as tirzepatide will become a central part of how we help people living with obesity to live longer and healthier lives.”

However, NICE also advised that doctors should stop prescribing Mounjaro if the patient has not lost at least 5% of their body weight within six months.

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