The U.K.’s National Institute for Health and Care Excellence has endorsed the use of Eli Lilly’s Zepboundfor weight management in patients with BMI of 35 kg/m2 and above and at least one weight-related comorbidity.
The U.K.’s National Institute for Health and Care Excellence on Tuesday recommended the use of Eli Lilly’s Zepbound (tirzepatide) for chronic weight management alongside dietary and lifestyle adjustments.
However, the institute—also known as NICE and which helps the National Health Service (NHS) decide what treatments to cover—endorsed the use of Zepbound only in those with body mass index (BMI) of at least 35 kg/m2 and with at least one weight-related comorbidity. NICE also recommended stopping treatment if patients fail to lose at least 5% of their initial body weight after six months.
“Clinical trial evidence suggests that tirzepatide with diet and exercise support is more effective compared with diet and exercise support alone,” NICE wrote in its draft guidance, while noting that “indirect comparisons” suggest that Zepbound may even outperform Novo Nordisk’s Wegovy (semaglutide).
Lilly had initially proposed to use Zepbound in people with a BMI of at least 30 kg/m2 but the institute argued that “the most likely cost-effectiveness estimates for this group are above the range that NICE considers an acceptable use of NHS resources,” according to the draft document.
Tuesday’s NICE recommendation for Zepbound comes after the agency in late 2023 also backed the use of its sister tirzepatide brand Mounjaro for type 2 diabetes. Like Zepbound, Mounjaro is recommended for patients with BMI of at least 35 kg/m2 and who have concomitant psychological or medical problems associated with obesity.
NICE’s endorsement for Mounjaro only covers patients for whom triple therapy including metformin is either ineffective or contraindicated, as well as those in whom weight loss would also result in significant health benefits.
Zepbound and Mounjaro are GLP-1 receptor agonists which work by inducing the secretion of insulin from the pancreas in response to blood glucose levels. The therapies also activate the GIP receptor, which helps regulate appetite.
Both treatments have quickly become top-selling drugs for Lilly. In the first quarter of 2024, the pharma revealed that Mounjaro’s sales nearly tripled year-over-year to $1.8 billion. Meanwhile, despite only winning approval in November 2023, Zepbound still managed to rake in more than $517 million during Q1.
Zepbound is helping Lilly establish and maintain its dominance in the lucrative weight-loss drug market, alongside competitor Novo Nordisk. The two frontrunners have been struggling to keep up with the overwhelming demand for obesity treatments, but supply lines have started stabilizing. Analysts now expect the market to reach $150 billion in value by the early 2030s.
Tristan Manalac is an independent science writer based in Metro Manila, Philippines. Reach out to him on LinkedIn or email him at tristan@tristanmanalac.com or tristan.manalac@biospace.com.
