Mounjaro: Why the wait on the NHS?

"Only 8 out of 42 health boards are offering Mounjaro... so what's the hold up?"

You've guessed it - Mounjaro is in the news again due to the latest controversy of the King-Kong weight loss jab being touted as 'available' on the NHS.... so what exactly is going on? Why are thousands of patients still waiting for a treatment that could transform their lives?

Mounjaro was meant to be rolled out across the NHS in England from 23 June for those with the highest clinical need under an agreement between NHS England and the National Institute for Health and Care Excellence (NICE). But Freedom of Information requests by Sky News reveal a postcode lottery, with only eight of 42 NHS Integrated Care Boards (ICBs) in England revealing that they were providing treatment to patients, and many of the rest unable to guarantee when it would be available, prompting accusations of a "postcode lottery".

Many providers will not make it available until autumn, while nearly half of NHS boards said they will cap the number of people they treat due to a lack of funding. The research shows that at least 19 will place such a cap on how many eligible patients they would treat in the first year.

Dr Jonathan Hazlehurst, an obesity specialist at University Hospitals Birmingham, said many patients were desperate for treatment - and Mounjaro may be a hopeful aid for those eligible.

Dr Jonathan Hazlehurst said the delay in rolling out Mounjaro was 'clearly grossly unfair'

"Giving people open promises and setting them up for disappointment and failure is clearly grossly unfair," he said. "That's what the current system is doing."

NICE said in December that the NHS should offer Mounjaro to patients with a BMI over 40 and at least four clinical conditions related to their weight, such as heart disease or type 2 diabetes.

It calculated from NHS England data that there were 97,500 patients who should be treated in the first year.

But Dr Hazelhurst says NHS England has only provided funding for just over 22,000 patients.

"It shows that there's a lack of political will to fund this adequately," he said. "NHS England says that obesity costs the NHS £11.4bn per annum as a pure NHS cost.

"Yet we can't even afford to properly fund the rollout of a life-changing drug in year one. That just doesn't make any sense."

Gary - who doesn't want his surname used - weighs 25 stone (158kg) and becomes severely out of breath after climbing only a few stairs.

Gary - who doesn't want his surname used - weighs 25 stone (158kg) - is struggling to find Mounjaro

He is eligible for treatment with Mounjaro under the agreed NHS guidelines. But his surgery said "no" and told him it would be at least the autumn before the drug would be available in the Hampshire area.

"They said to us that September would be the earliest they going to look at it and then the criteria might change, so there's no knowing if I'm going to get it," he said.

"I was so excited when I read about this drug. If I had the drug and lost some weight, it could help me move around, it could help me go fishing again, all kinds of things.

"It's not for vanity. It would be a life changer."

There are 3.4 million people in England who would qualify for treatment under the NICE eligibility criteria. But NHS England has said it will take 12 years to assess and prescribe to those who need it.

Dr Hazlehurst said there would never be such a slow rollout with a new cancer treatment - and yet, obesity also kills.

"There's a huge amount of stigma that drives things to do with obesity care all across the system," he said. "The 'eat less, move more' nonsense doesn't help. That is a really unhelpful, harmful and stigmatising approach, particularly in an age of effective treatment."

NHS England said it had "fully supported the rollout" of Mounjaro

A spokesperson for NHS England said it had "fully supported the rollout" of Mounjaro.

They said: "We issued guidance and provided funding in March to all Integrated Care Boards to support treatment costs, enable scaling of services and provide wrap-around care, including digital support services."

So the big question is... what exactly is the hold up and how long will it last for?