Monday, December 23, 2024

‘King Kong’ weight loss jab set to be free on the NHS: spending watchdog gives green light to powerful new drug Mounjaro, a year after refusing to approve it

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The ‘King Kong’ of slimming jabs will be made available on the NHS, health chiefs today announced. 

Under current guidelines, only those with type 2 diabetes who do not have the condition under control are eligible to get Mounjaro via the health service. 

But draft guidance by the UK’s drugs watchdog has now recommended its usage to be expanded for weight loss in those who are severely obese.

It comes just a year after the National Institute for Health and Care Excellence (Nice) said it needed ‘more evidence’ before it would give the drug the green light for NHS weight loss use.

The move shocked specialists in diabetes and obesity treatment at the time, who agreed the treatment, given in weekly self-injections, is highly effective. 

Clinics are charging around £40 for a week’s supply of Mounjaro, or tirzepatide. Patients taking it can expect to lose up to 20 per cent of their body weight, data suggests. Anyone with a BMI above 30 — the technical classification for obesity — can get a private prescription 

Mounjaro, the brand name of the drug tirzepatide, has already been rubber-stamped by US health chiefs for weight loss. 

In February it was also made available privately in Britain, with clinics charging around £40 for a week’s supply. 

Studies have found the drug, made by US pharmaceutical giant Eli Lilly, could help obese people lose more than 20 per cent of their body weight in under a year and a half. 

Under the draft guidance, Nice has recommended anyone with a BMI of at least 35 and one weight-related comorbidity be eligible for the drug.

Eli Lilly had proposed it be available to anyone with a BMI of 30 or over and at least one weight comorbidity.

But ‘cost effectiveness estimates’ were ‘above the range that Nice considers an acceptable use of NHS resources’, the watchdog added.  

Mounjaro would provide an alternative to Wegovy — or semaglutide — which has also been in short supply due to overwhelming demand. 

Tirzepatide works by suppressing two appetite-regulating hormones, making people feel fuller for longer while also making them experience fewer food cravings. 

The jab should be supplied in a four-dose pen, which provides a month’s treatment when used once a week, Nice said.

It was previously only available in single doses.

Patients in the US are already able to get the jab for weight-loss ‘off-label’ from some doctors, with many sharing their unbelievable transformation. 

One overweight man claimed the medicine helped him shed up to 100lb (45.4kg).

Before-and-after pictures show the transformation of Matthew Barlow, a 48-year-old health technology executive living in California.

According to the latest data digestive problems were the most commonly reported side effects of tirzepatide, the active ingredient of Mounjaro. These included about one in five participants suffering from nausea and diarrhoea, and about one in 10 reporting vomiting or diarrhoea

According to the latest data digestive problems were the most commonly reported side effects of tirzepatide, the active ingredient of Mounjaro. These included about one in five participants suffering from nausea and diarrhoea, and about one in 10 reporting vomiting or diarrhoea

He began using the drug last November. At the same time, he also changed his diet and lifestyle, as recommended. 

‘Psychologically, you don’t want to eat. Now I can eat two bites of a dessert and be satisfied,’ he said.

Meanwhile, one TikTok user called Emily, claimed she had lost 140lb (63.5kg) since startling on the weight-loss injections.

‘The incredible amount of joy that is in me when I look in the mirror now is insane,’ she said. ‘I used to cry at myself in the mirror. Now I feel like one of the cool kids.’ 

Professor Sir Stephen O’Rahilly, Cambridge University‘s director of the medical research council metabolic diseases unit, today said: ‘Given the very positive recent results of large, randomised control trials with this drug and its beneficial effects on a range of outcomes, this decision is not surprising. 

‘We are clearly in a new era of obesity management where, for the first time, we can have access to medicines which are effective and, though not without some side effects, largely safe. 

‘This class of injectable drug is currently expensive, providing particular challenges to a taxpayer-funded health system like the NHS

‘In the longer term, these drugs significantly reduce the risks of developing distressing and expensive complications such as Type 2 diabetes, heart attacks and kidney failure but their cost provides an immediate financial challenge at a time when NHS budgets are tight.’

He added: ‘The genie is out of the bottle here. Safe and effective drug treatment for obesity is not going to go away. 

‘We must continue to work on making our environment less promoting of obesity. But that will take political will and time.’

Some Americans are already using it 'off label'.  One of these is Matthew Barlow, a 48-year-old health technology executive living in California, who said he has lost more than 100 lbs since November 2022 by using Mounjaro and changing his diet

Some Americans are already using it ‘off label’.  One of these is Matthew Barlow, a 48-year-old health technology executive living in California, who said he has lost more than 100 lbs since November 2022 by using Mounjaro and changing his diet

Meanwhile, Professor Naveed Sattar, an honorary consultant and expert in cardiometabolic medicine at the University of Glasgow, said Nice’s updated guidance was ‘pragmatic’.

He added: ‘I think the guideline appears pragmatic given we have to start somewhere and that for now, help people at greater risks of more rapidly developing other obesity related comorbidities, even if many others at risk will initially be denied. 

‘As drug costs come down and more evidence accrues on additional benefits, BMI thresholds for treatment will come down. 

‘However, with so many already living with BMIs over 35, there will be considerable work to treat and care for this group of individuals in the NHS.’

But like all drugs, Mounjaro is not without side-effects.

The MHRA has warned the drug may affect how well the contraceptive pill works in obese or overweight female patients. 

Other potential side effects include nausea, diarrhoea, vomiting — which usually goes away over time — and constipation.

Low blood sugar is also ‘very common’ in patients with diabetes, the agency added. 

One trial involving 900 participants also found a fifth suffered from nausea and diarrhoea, and about one in ten reported vomiting or constipation.

Other people taking the drug outside clinical trials have reported experiencing hair loss while taking Mounjaro

There has also been a suggested link to an increased risk of cancer from the jab.

The European Medicines Agency said this year that research on rodents has suggested the artificial hormones packaged in tirzepatide could raise the risk of medullary thyroid cancer

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