June 16, 2024

The medical treatment regulator for England has approved a second drug to fight obesity, giving patients and doctors what it says is a more effective alternative to semaglutide.

The National Institute for Health and Care Excellence (Nice) issued draft guidelines on Tuesday recommending that very obese people should be prescribed tirzepatidewhich is marketed in the UK as Mounjaro.

Doctors can give it to people England who have a body mass index of at least 35 and at least one weight-related comorbidity, such as heart disease, type 2 diabetes, or sleep apnea.

Nice’s draft guidelines said: “Clinical trial evidence suggests that tirzepatide with diet and exercise support is more effective compared with diet and exercise support alone.

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

Semaglutide, better known as Wegovy, was the first anti-obesity drug approved by Nice, back in 2022. Novo Nordisk makes Wegovy while Mounjaro is made by Eli Lilly.

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

Nice’s move is likely to increase the number of people taking obesity drugs.

Clinical trials showed that tirzepatide helped users shed 22.5% of their body weight over 72 weeks, compared to 16% over 68 weeks with Wegovy.

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

Nice said a four-week supply of pre-filled pens from Mounjaro would cost between £92 and £122, depending on the size of the dose, but it would be a good use of NHS resources as it would reduce the chances of patients suffer other serious health complications.

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People prescribed Mounjaro will be able to take it for as long as needed, while Nice has imposed a two-year limit on the use of Wegovy.

Dr Simon Cork, a senior lecturer in physiology at Anglia Ruskin University, said that although Nice had set a threshold BMI of 35 for receiving Mounjaro, meaning “very few patients” would be given it, others people will try to get it like they did with Wegovy.

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

However, Nice also said that doctors should stop prescribing Mounjaro if the patient has lost less than 5% of their body weight within six months.

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