Tirzepatide prescribing and pricing

As you may already be aware, we are in the process of establishing a new weight management service in north east London on behalf of primary care. This will bring us in line with NHS England’s phased implementation of access to tirzepatide for weight management.

NHS England has adopted a phased approach to ensure tirzepatide is initially available only to those patients with the highest clinical need and most likely to benefit. Eligibility is determined by the presence of co-morbidities alongside a qualifying BMI, in accordance with the national commissioning guidance.

We recognise the significant number of patient queries regarding access to tirzepatide. From September 2025, the price of all strengths of tirzepatide will increase, which we anticipate will lead to further requests for NHS prescribing.

Patients accessing tirzepatide privately may not be eligible for NHS treatment, unless they meet the NHS eligibility criteria (see link below). Current eligibility criteria (priority cohort 1) are based on the NHSE commissioning guidance. The threshold for NHS prescribing in obesity management is therefore higher than the product licence indications and the original NICE TA1026.

NEL Position

To ensure fairness, equity and adherence to national guidance:

• Tirzepatide for weight management should only be prescribed on the NHS where patients meet the NICE eligibility criteria and as per NHSE’s Interim Commissioning guidelines that provides a framework to implement the NICE TA and NICE Funding Variation for tirzepatide during its first three years of delivery within the NHS.
• Prescribing outside these criteria is not supported
• Prescribing of tirzepatide for obesity management should not be initiated in primary care
• All clinicians must also note it is a condition of their treatment that patients on tirzepatide for weight management should receive behavioural support.  It is the responsibility of the current prescriber to ensure that this is in place and that patients are engaging with this support. There are local and national services, please contact the NEL Pharmacy and Medicines Optimisation Team for more information.

We are currently working with specialist weight management services and key stakeholders to commission the tirzepatide service on behalf of primary care. Referrals by GPs to the weight management service for tirzepatide are expected to go live in October 2025.

The detailed eligibility criteria is highlighted in the NHSE commissioning guidance. This guidance sets out the prioritisation criteria for the first three years of tirzepatide NHS prescribing (via weight management service on behalf of primary care). Information for patients on access to tirzepatide can be accessed here.

We appreciate this will be a challenging time, given both the clinical demand and the cost implications. We will continue to provide updates and resources to support you as the service is implemented.

Thank you for your ongoing commitment to patient care.