(Bloomberg) -- England’s National Health Service will begin rolling out Eli Lilly & Co.’s blockbuster weight-loss drug Mounjaro over the next few months, though the medication will initially be made available to only a small proportion of the patients who could benefit from it.
The decision to limit access to those with the greatest need comes as the NHS tries to keep a handle on what could be a ballooning obesity drugs bill. The final draft guidance from England’s drug price regulator, the National Institute for Health and Care Excellence, took into account NHS England’s request to roll out the medication over a period of 12 years.
Some 3.4 million people in England would meet the criteria for taking Mounjaro, which include a body mass index of more than 35 and at least one weight-related illness. After the end of three years, however, only about 220,000 people are expected to have received the drug — just over 6% of the eligible population.
“Only those with the highest clinical need will be treated initially,” said Jonathan Benger, NICE’s chief medical officer, in a statement. “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.”
Patients already receiving specialist weight-management services will be the first to access Mounjaro. They will be able to get the drug within 90 days of the publication of the final guidance — expected on Dec. 23. Additional patients with the greatest clinical need will only begin to be offered Mounjaro after 180 days.
The recommendation is based on a list price of £122 ($154.65) for four pens of the injectable medicine, which is administered weekly. The total cost to the NHS in England will be around £317.2 million a year by the third year of the rollout.
Mounjaro, known as Zepbound in the US, outperformed rival Novo Nordisk A/S’s Wegovy in the first head-to-head trial of the two medicines. In a study sponsored by Lilly, people treated with Zepbound lost an average of 20% of their body weight over 72 weeks, while those who got Wegovy shed 14%.
Many patients already access Mounjaro and Wegovy in England with private prescriptions outside of the NHS network. Wegovy is only available within the NHS for patients using specialist weight-management services.
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