Guidance on tirzepatide prescribing for obesity in England released

NHS England has published a framework for commissioners to implement the recommendations of the NICE technology appraisal guidance on the use of tirzepatide as an option for the management of overweight and obesity (TA1026). The document provides details on eligible patient cohorts, the prioritisation strategy and phased implementation of tirzepatide across primary care settings and specialist weight management services.

Obesity has become a major public health concern and has imposed a huge economic burden on the NHS and wider economy, underscoring the need for more cost-effective and scalable treatments and management approaches.

The efficacy of tirzepatide (brand name Mounjaro) for weight management is well documented in clinical trials, and NICE recommended provision of the weekly injection in primary care in 2024. So that sustainable support could be provided, NICE accepted NHS England’s request for a phased rollout and asked them to produce a detailed plan for the pilot phases.

The new NHS England approach considers comorbidities as the main qualifier in clinical prioritisation, in association with BMI. The phased approach will cover the first 3 years of implementation across primary care and specialist weight management services. Anyone prescribed tirzepatide in primary care must also receive wraparound support, which incorporates nutritional and dietetic advice as a minimum and access to behavioural change components.

Integrated Care Boards are required to meet the costs of funding access to tirzepatide for the treatment of obesity in primary care settings from 23 June 2025. All ICBs will receive a funding allocation for 2025/26 to cover the estimated additional costs of the weight-loss drugs and to support the new service within primary care. To address health inequalities, the allocation is calculated based on obesity prevalence rates at ICB level.

In June, NHS England will also publish a template to ensure that essential data is captured in a structured way within practice IT systems.

The full interim commissioning guidance can be read here.