Mounjaro (Tirzepatide) access in Cheshire and Merseyside

People in England over the age of 18 living with obesity and weight-related health issues, will be able to access the weight loss drug Tirzepatide (Mounjaro®). 

Tirzepatide is currently prescribed for the treatment of type 2 diabetes mellitus but will now also be available for weight loss purposes. 

This is unlikely. We are following a nationally developed staged approach that will be used to help cope with the huge demand this will place on existing healthcare services. This allows the prescribing of Tirzepatide and the appropriate support for patients to be set up in a safe way. This staged approach is also being followed in Cheshire and Merseyside. 

Tirzepatide will initially be offered to individuals facing the most significant health risks related to their weight. 

At present, you CANNOT gain access to Tirzepatide (or other weight loss drugs) directly from your GP. In line with the rest of England, we are making access to Tirzepatide available in community/primary care settings this summer to those eligible under the NHS England Commissioning Guidance.

Please keep monitoring this website as we will update it when your local service is open to referrals. Your GP can not refer you for access to tirzepatide before this.

The National Institute of Health and Care Excellence (NICE) published recommendations for tirzepatide but recognised the need for a gradual approach to prioritise treatment for patients. So, NHS England developed qualifying criteria and patient groups who should be able to access tirzepatide first.

To be able to access the drug in the first 3 years, patients must meet the criteria we have outlined below. 

NICE has committed to reviewing access criteria after year 3 to evaluate the implementation and delivery of Tirzepatide.

Further details on the prioritisation of availability of Tirzepatide can be found in the NHS England Interim Commissioning Guidance for Tirzepatide.

Please keep an eye on this website as we are in the process of establishing new community weight loss prescribing services, these will be in place in the next couple of months. Please don’t contact your GP before this date, as they won’t be able to help yet.  

If you don’t meet the new NHS rules, you won’t be able to get Tirzepatide through the NHS.

NICE has not approved these drugs for prescribing in GP/Community Settings so they are not available in our community weight loss prescribing service.

The weight loss medicine tirzepatide also known as Mounjaro ® is a GLP-1/GIP agonist. Other medications such as semaglutide (Wegovy ®), liraglutide (Saxenda ®), are known as GLP-1 agonists. They mimic gut hormones released by the body after eating, telling the brain you are full, they also slow down the time it takes the stomach to empty and help control blood sugar levels. 

Until now most of these medicines have been used in the NHS to treat diabetes, to help control blood sugar levels helping improve diabetes and other health conditions. 

Tirzepatide (Mounjaro®) can only be prescribed by a healthcare professional alongside programmes that support people to lose weight and live healthier lives, by making changes to their diet and physical activity. Tirzepatide (Mounjaro®) is an injection, that you inject yourself once a week. 

More information can be found here: GLP-1 medicines for weight loss and diabetes: what you need to know - GOV.UK 

Tirzepatide might not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss. There are other options available including weight loss programmes that use tried and tested methods such as lifestyle and behavioural changes, nutrition and physical activity advice. Please speak to a healthcare professional about the best option for you in your local area.

There are a range of local weight management services which offer support in losing weight. These will vary depending on where you live. These include services commissioned by our local authorities.

The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access.

More information about obesity treatment is available via the NHS website.

The NHS Type 2 Diabetes Path to Remission Programme is available if you are aged 18 to 65, have a diagnosis of type 2 diabetes within the last 6 years and have a BMI over 27 kg/m2 (for people from White ethnic groups) or over 25 kg/m2 (for people from Black, Asian and other ethnic groups).

Adults can access the NHS Diabetes Prevention Programme if they have had a blood test in the last year that shows they are at risk of diabetes.

There are also a range of NHS online tools you can access.

Lose weight - Better Health - NHS

How to be more active - Better Health - NHS

NHS Food Scanner app

We also know there will be many people who do not qualify for weight loss medications which may cause disappointment and/or exacerbate new and existing mental health and wellbeing issues. People may find NHS talking therapies a helpful source of support.

For people meeting the eligibility criteria described in section 3, NHS commissioned community-based weight loss prescribing services can support you in prescribing Tirzepatide. You will also receive support in relation to your lifestyle alongside the medication.

Every patient prescribed Tirzepatide on the NHS is required to participate in a specifically designed ‘wrap-around’ care service, as stipulated under NICE guidance. This focuses on diet, nutrition and increasing physical activity. Patients cannot be prescribed 

Tirzepatide if they do not wish to get the wrap-around care support. 

When you are prescribed Tirzepatide the person making the prescription will refer you to this service (provided by Reed Health who also locally provide the Diabetes Prevention Programme) who provide this support in Cheshire and Merseyside.  

At present there are no “Right to Choose” providers, including Oviva, that meet our local commissioning policy and as a result you CAN NOT be referred under right to choose.  If a provider becomes eligible, we will update this web page.

Like all medications, Tirzepatide can have side effects, and healthcare professionals should discuss these with you. The medication comes with a patient information leaflet listing common side effects, including:

• feeling sick
• indigestion
• constipation
• diarrhoea

There can be some more serious side effects, such as low blood sugar, gallstones and inflammation of the pancreas (pancreatitis).

Tirzepatide is a new medication, and any side effects should be reported through the Yellow Card Scheme, the government’s system for tracking medicine-related side effects.

NICE guidance recommends that, if you do not lose enough weight (5%) after 6 months of being on the highest dose you can manage, Tirzepatide should be stopped. This is because the medication is not working as well as it should for you. 

Currently, there is no specified time limit for Tirzepatide prescriptions. The decision to continue or stop Tirzepatide should be discussed with an appropriate healthcare professional.

If you are trying to get pregnant, you should have a discussion with an appropriate healthcare professional. There are specific recommendations about when to stop the medication before trying to get pregnant. Tirzepatide is not recommended in pregnancy or during breastfeeding because we have limited safety data. It should be stopped if you become pregnant.

The Faculty for Sexual and Reproductive Health has produced a patient information leaflet about how these medications affect contraception, like the pill.

Patients can continue taking Tirzepatide if they are prescribed it by the NHS to manage their diabetes. If you have any questions, contact a suitable healthcare professional.

If patients are using Tirzepatide bought privately, they may be able to access the medication through an NHS prescription if they meet the NHS qualifying criteria outlined in section 3. However, patients should not gain advantage over other patients waiting for NHS care.  You will also be expected to engage with the wrap around support that is mandated alongside tirzepatide for weight loss.

It is important that your GP is aware you are taking Tirzepatide even if it hasn’t been prescribed by the NHS. It may affect your health and interact with other treatments.

A healthcare professional will advise you if you are eligible and if it is clinically appropriate for you to receive Tirzepatide as part of your care. This will reflect the criteria in section 3. 

Every patient prescribed Tirzepatide on the NHS is required to participate in a specifically designed ‘wrap-around’ care service, as stipulated under NICE guidance. This focuses on diet, nutrition and increasing physical activity. Patients cannot be prescribed Tirzepatide if they do not wish to get the wrap-around care support. 

When you are prescribed Tirzepatide the person making the prescription will refer you to this service (provided by Reed Health who also locally provide the Diabetes Prevention Programme) who provide this support in Cheshire and Merseyside.  

If you do not engage with this “wrap around” support you may have your prescription of Tirzepatide stopped.

Wraparound care is the name given to the support programme that must be provided alongside tirzepatide (Mounjaro®).  
This includes:

•    Advice on healthy eating and nutrition
•    Support to increase physical activity
•    Help with making long-term lifestyle changes

You must agree to take part in this support programme in order to be prescribed tirzepatide for weight loss.

Normal prescription charges will apply unless you are entitled to free NHS prescriptions (for example, because you have a medical exemption certificate).