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A new task group is to be set up to assess how weight-loss drugs will be made available on the NHS in Wales. It will examine how tirzepatide – also known as Mounjaro – and future drugs can be safely delivered in a “scalable and sustainable” way by the NHS.
The commitment is one of 23 actions outlined in the Healthy Weight delivery plan 2025 to 2027, newly published by the Welsh Government’s Healthy Wales programme. Many of the measures focus on healthier lifestyles, acknowledging that more than 60% of adults in Wales overweight or obese.
Weight-loss injections like Mounjaro are today’s must-have medicines in first-world economies. Users have included celebrities like Elon Musk, Serena Williams and Rebel Wilson. Last month, Carolyn Harris, the Labour MP for Neath and Swansea East, revealed she shed more than eight stone after she began taking Mounjaro in October 2024.
In Wales, primary care provision of weight-loss drugs such as Mounjaro and Wegovy (Semaglutide) is lagging behind England, where commissioning guidance was issued late last year: currently it can only be prescribed by specialist NHS weight management services – and only in combination with increased exercise and lower-calorie diets.
In England, GPs were permitted to prescribe Mounjaro to “prioritised” patients with the highest needs from late June. However Welsh GPs have yet to get the go-ahead.
Where the drugs are available from specialist services in Wales, the qualifying threshold is often higher than in England. Sign up now for the latest news on the North Wales Live Whatsapp community
In North Wales, Betsi Cadwaladr University Health Board (BCUHB) will only prescribe to people with a Body Mass Index (BMI) over 45. In England, the drugs are mostly restricted to those with a BMI of over 35, though some health boards have reportedly increased this threshold.
The Welsh Government has stressed that NHS England’s commissioning guidance “does not apply in Wales”. It added: “Work is currently being undertaken to determine if and how tirzepatide and other weight loss medications licensed in the future, will be made available in the NHS in Wales.”
Earlier this year, the North Wales health board confirmed that, for now, the drugs will only be available in “very limited circumstances” to those with the most serious clinical need. The health board added: “We know that many people feel disappointed that they are not currently able to access these medications via NHS prescription. The Mental Health Hub provides information on sources of support for mental wellbeing if needed.”
Weight-loss drugs like Mounjaro and Wegovy partly work by mimicking a hormone that suppresses appetite and makes people feel fuller. Studies have suggested patients can lose as much as a fifth of their body weight.
England’s roll-out is being spread out slowly, over 12 years, to “protect other vital NHS services”, such is likely to be the scale of demand. The National Institute for Health and Care Excellence (Nice) said only about 220,000 people may benefit from the drug during an initial three-year period – fewer than 10% of the 3.4m people with a BMI over 35 and at least one weight-related illness.
Wales’ Healthy Weight delivery plan focuses on prevention. Its approach pledges to support families on low incomes, provide healthier food in schools and hospitals, increase opportunities for exercise and restrict the promotion of foods high in fat, sugar and salt.
But Dr Hilary Williams, vice president of the Royal College of Physicians (RCP) in Wales, said the All-Wales Weight Management Pathway (AWWMP), which provides specialist weight-loss services, must be geared to meet “unprecedented demand” for weight-loss drugs.
She said: “Strengthening the AWMP is essential to ensure the NHS can keep pace. Many Local Health Boards are struggling to meet demand, with some temporarily closing or restricting their lists.
“While the plan rightly emphasises the importance of embedding a healthy lifestyle and physical activity in early years, adults living with, or at risk of developing, overweight and obesity, must be equally supported.”
NHS restrictions on access to weight-loss drugs have raised fears of a two-tier system which benefits mostly the most well-off. It’s estimated that 1.5m people in the UK use these drugs, with more than 90% paying for them privately at a cost of between £100-£350 a month.
In the UK, Mounjaro manufacturer Eli Lilly is expected to increase the non-NHS list price by as much as 170%, to give price parity with other countries. The company has since agreed a deal with UK distributors, restricting the rises.
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