Less than half of eligible patients can access weight-loss drug

Less than half of England has access to tirzepatide (Mounjaro) through their GP practice despite the NHS roll-out of the weight-loss drug that officially started over two months ago, an investigation by The BMJ has found.

Due to the large number of people who could benefit from tirzepatide – an estimated 3.4 million people – and the drug’s price, NHS England and NICE agreed the drug would be phased in over a 12-year period, which commenced on 23 June 2025. Yet just 18 out of 42 commissioning bodies (43%) across the country confirmed that they have started prescribing tirzepatide in line with this roll-out plan.

The data also shows that despite NHS England stating that it expects 70% of eligible patients to come forward for treatment, just nine Integrated Care Boards (ICBs) confirmed they have been allocated enough NHS funding to cover at least 70% of their eligible patients.

Experts warn the lack of funding and poor communication are driving ‘distress and uncertainty both in patients and primary care’ and have left ICBs in a difficult financial situation.

Of the 40 ICBs that responded to The BMJ’s request, four reported that the NHS funding they had received covers just 25% or less of their eligible patients, with Coventry and Warwickshire faring the worst at 21% of its patients.

And five ICBs have said they are already considering further tightening the tirzepatide prescribing criteria or rationing the treatment beyond this 12-year phased plan.

Practices have posted notices urging patients not to contact their GP as they cannot provide the drug.

Jonathan Hazlehurst at the University of Birmingham, commented: ‘NHS England is talking about treating 220,000 patients in the first three years, but we can see that the initial funding for year one clearly only covers approximately 10% of that.’ He also warned that there are patients who would ‘benefit from really urgent and immediate treatment’ with tirzepatide, but are not currently considered a priority.

The Association for the Study of Obesity says the deficit in funding compared with need has set up a ‘postcode lottery’ of who can access obesity care.

The BMJ contacted NHS England for comment, but had received no response at the time of publication.

Mahase E. BMJ 2025;390:r1855 https://www.bmj.com/content/390/bmj.r1855