The National Institute for Health and Care Excellence (NICE) have published guidance approving the use of tirzepatide (brand name Mounjaro) for treating type 2 diabetes in England and Wales.
The NHS has three months to make tirzepatide available to be prescribed.
We are seeking to better understand what supply might be available in early 2024.
What is Mounjaro?
Tirzepatide, brand name Mounjaro, is a GLP-1 analogue that is combined with a GIP analogue (short for glucose-dependent insulinotropic polypeptide). It is manufactured by pharmaceutical company Eli Lilly.
Tirzepatide is administered through once-weekly injections. It works by activating both GLP-1 and GIP receptors to increase the level of incretins in the body. These incretin hormones increase the production of insulin in the body and decrease the glucose produced by the liver, lowering blood glucose.
Research into the use of tirzepatide to treat type 2 diabetes found it led to greater improvements in blood glucose management and weight loss when compared to other type 2 diabetes medications.
What will tirzepatide be used for?
NICE has recommended tirzepatide to be used as an alternative to other GLP-1s to treat adults living with type 2 diabetes, along with diet and exercise, if they have a BMI of 35kg/m2 or more and have additional psychological or medical complications.
It could also be prescribed to people living with type 2 diabetes who have a BMI below 35kg/m2 where using insulin would affect their occupation due to the risk of hypoglycemia, or for those who would see improvements in other obesity-related health issues with weight loss.
This means that tirzepatide will be available through your healthcare team who would assess whether this is the best treatment for you.
How will this affect GLP-1 RA supply issues?
We are seriously concerned about the ongoing shortages of GLP-1 medications which are having serious implications for many people with type 2 diabetes.
It is currently unclear what implications the approval of tirzepatide will have on the shortages. We are continuing to speak with the Department of Health and Social Care about the need for this issue to resolved as a matter of urgency.
We welcomed the government’s guidance to restrict off-label prescriptions of GLP-1 medications while there is an ongoing shortage impacting people with type 2 diabetes, however we are seeking clarification as to whether new guidance will be issued to ensure that tirzepatide can be prescribed to people with type 2 diabetes who meet the criteria.
Does tirzepatide have side effects?
Like all medications, tirzepatide can have side effects. Common side effects of tirzepatide can include feeling sick, indigestion, constipation and diarrhoea, while less common side effects include pancreatitis and gallstones.
Before starting treatment with tirzepatide, it is important to take individual advice from your healthcare team. You should report any side effects, if you experience any, while taking the medication.
Will tirzepatide be approved across the UK?
Tirzepatide has been approved for use within England and Wales. We anticipate that it will be made available for use within Northern Ireland in line with NICE recommendations, subject to necessary approvals. The Scottish Medicines Consortium (SMC) is responsible for approving drugs for use on the NHS in Scotland. We are awaiting confirmation of a timeline for the SMC’s appraisal of tirzepatide.
NICE are also reviewing the use of tirzepatide for treating people living with obesity. The outcome of this is not expected to be published until March 2024.
Douglas Twenefour, Head of Care at Diabetes UK, said:
“We welcome NICE’s decision to approve tirzepatide (Mounjaro) to be prescribed on the NHS as this will provide another effective treatment option for managing type 2 diabetes. It is very promising that the trial data showed great improvements in blood glucose management and weight loss.
“The current GLP-1 medication shortages are causing stress and uncertainty for many people with type 2 diabetes. While the approval of tirzepatide is welcome, we are calling for more action to ensure ongoing and sufficient supply of these medications to people with type 2 diabetes.”
