NICE technology appraisal guidance TA1026 states:
Tirzepatide is recommended as an option for managing overweight and obesity, alongside a reduced-calorie diet and increased physical activity in adults, only if they have:
an initial body mass index (BMI) of at least 35 kg/m2 and
at least 1 weight-related comorbidity.
Use a lower BMI threshold (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.
If less than 5% of the initial weight has been lost after 6 months on the highest tolerated dose, decide whether to continue treatment, taking into account the benefits and risks of treatment for the person.
These recommendations are not intended to affect treatment with tirzepatide that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.
Tirzepatide is also recommended in NICE technology appraisal guidance 924 as an option for treating type 2 diabetes alongside diet and exercise in certain situations.
Prioritisation of cohorts for treatment will be based on a prioritisation statement led by clinical need and produced by NHS England. This will consider both referral prioritisation in specialist weight management services and priority cohorts in other settings, including primary care-based services.
Integrated care boards (ICBs) are required to fund tirzepatide:
within 3 months for everyone accessing specialist weight management services at that time, and subsequently
from 6 months to support a phased introduction of delivery to other eligible cohorts.
NHS England will make available to ICBs an interim commissioning policy outlining how patient cohorts should be prioritised and the service models that are recommended during this initial implementation within 4 weeks of final guidance publication.
NICE will evaluate data collected during the first phase of guidance implementation, within the first 3 years. It will consider whether to revise the maximum total 12‑year implementation period and whether NHS England should produce an updated interim commissioning policy for the remaining implementation period.