NICE says more evidence needed to approve new weight loss drug

NICE has not recommended tirzepatide (Mounjaro) for type 2 diabetes patients in its latest guidance, despite studies showing that it results in better glucose control and weight loss benefits compared to semaglutide or insulin therapy.

The weight reduction was more pronounced with higher doses of tirzepatide, while the effect on glucose levels seemed less dose-dependent.

According to a meta-analysis by the drug’s manufacturer Eli Lilly, similar effects were also observed against other GLP-1 receptor agonists, but the committee says there were uncertainties in the clinical evidence, and they have now asked the company to provide more data.

However, the main reason the drug has not been approved for NHS use is due to concerns about the drug’s cost-effectiveness. Currently, the price of Mounjaro is commercial in confidence, and it will not be announced until final guidance is published.

NICE have also Eli Lilly to provide evidence showing how the company’s model results compare with other economic models for diabetes, as currently, it is unclear how accurately the model predicts the long-term health benefits of tirzepatide compared with other GPL-1 receptor agonists.

This makes it more difficult to discern whether the drug is a cost-effective weight loss solution for type 2 diabetes patients.

More evidence needed to evaluate clinical and cost effectiveness of the weight loss drug

Similar to other weight loss drugs, tirzepatide is taken weekly by injection. The drug would be offered as an option later in the treatment pathway to offer the NHS an alternative to glucagon like peptide 1 (GLP-1) receptor agonists such as dulaglutide, liraglutide and semaglutide which are already recommended for use in the NHS.

The independent NICE committee recognised the importance of new treatment options given that fewer than two-thirds of the adults with type 2 diabetes have adequate glucose control when using current treatment options.

However, Helen Knight, director of medicines evaluation, at NICE, says currently, the evidence is simply not strong enough to support its use as an NHS treatment.

She said: “Type 2 diabetes is becoming more prevalent in society, so new treatment options are needed to help people with it to control their blood-glucose levels.

“Our committee can see the promise in tirzepatide but it requires more evidence to be able to evaluate both its clinical and cost effectiveness.”

“We look forward to working with the company to ensure our committee receives the evidence it has requested so at their next meeting they can fully understand the benefits and the value of this new treatment option,” she added.