Thousands of people who could benefit from Mounjaro ‘missing out on NHS care’

Thousands of people who could benefit from the weight loss jab Mounjaro on the NHS are missing out due to funding issues, figures suggest.

Fewer than half (18 out of 42) of commissioning bodies across England have started prescribing the drug on the NHS in line with health service guidance, according to data gathered by the British Medical Journal (BMJ).

NHS England has put in place a phased rollout of the drug over a period of up to 12 years, but the data suggests even patients who are eligible now cannot get the drug.

The vast majority of patients on Mounjaro currently pay for it privately.

According to the BMJ, few integrated care boards (ICBs) have been allocated enough NHS funding for patients who could be treated on the health service.

It said only nine had the funding needed to cover at least 70% of their eligible patients.

Four ICBs told the BMJ the NHS funding they had received covered just 25% or less of their eligible patients, with Coventry and Warwickshire faring the worst.

That ICB told the BMJ it had received funding to cover just 376 patients, despite identifying 1,795 eligible patients in the first year of rollout.

The rollout began on June 23. Eligible patients in the first year include those with a body mass index over 40 and other complicating illnesses such as high blood pressure, obstructive sleep apnoea, cardiovascular disease, and type 2 diabetes.

Five ICBs included in the BMJ research said they were already considering further tightening the prescribing criteria or rationing the treatment beyond the 12-year phased plan.

According to NHS England calculations, around three million patients may be eligible for the jab under current criteria.

It has put in place the phased rollout after concerns GPs would be overwhelmed by requests.

NHS England previously said if all eligible patients turned up for the drug in the first year, and 70% of those were started on treatment, the impact on primary care and general practice would be profound and take up 18% of GP appointments.

A total of 40 of the 42 ICBs responded to the BMJ’s freedom of information request.

Dr Jonathan Hazlehurst, consultant endocrinologist and academic clinical lecturer at the University of Birmingham, said that although the central funding from NHS England was “extremely welcome” the rollout had so far been “significantly underfunded”.

He told the BMJ: “That clearly drives up distress and uncertainty both in patients and primary care and runs the risk of inequity in access to treatment, and that’s my biggest concern.

“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 emphasised that the lack of communication to the public about the difficulty in rolling out and funding Mounjaro was a major problem.

“If you’re going to have very strict (prescribing) rules, whether they’re right or wrong, you have to fund those very strict rules and have absolute clarity so patients and GPs know where they’re at, and that’s what we’re lacking at the moment.”

Professor Nicola Heslehurst, president of the Association for the Study of Obesity from the Newcastle University, said: “The deficit in funding compared with need is another blow for people living with obesity, who deserve evidence-based care to manage their health needs.”

She added that the current commissioning model had set up a “postcode lottery” of access to obesity care. “ICBs in more deprived locations will have increased demand for care and need to have the budget required to address obesity inequalities.”

A Department of Health and Social Care spokesman said:  “We expect NHS Integrated Care Boards to be making these drugs, which can help tackle the obesity crisis, available as part of the phased rollout, so those with the highest need are able to access them.

“As we shift the focus from treatment to prevention through our 10-Year Health Plan we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.”

On Wednesday, Wes Streeting pledged to do more to prevent people being “priced out” of accessing weight-loss jabs.

The Health Secretary said he wanted more people to get the drugs on the NHS after the manufacturer of Mounjaro said it was putting up prices in the private sector.

Eli Lilly said in August it was putting up the list price of the drug by as much as 170%, which could have meant the cost of the highest dose going up from £122 to £330 per month.

However, it has since been reported that the highest dose will be be sold to suppliers for £247.50.