Do the NICE criteria apply in Scotland and Northern Ireland?

NICE technology appraisals apply in England and Wales. Scotland has its own process via the Scottish Medicines Consortium (SMC). Northern Ireland follows a distinct commissioning process. Access timelines and criteria may differ across the four nations.

What is a Tier 3 weight management service?

NHS Tier 3 services are specialist, multidisciplinary weight management programmes offering intensive lifestyle intervention, psychological support and medical input. NICE TA875 and TA1026 require that GLP-1 medicines are initiated and managed within such services or equivalent specialist pathways in most cases.

Can I get Mounjaro or Wegovy if I don't meet the NHS criteria?

Individuals who do not meet NHS criteria may explore private prescribing routes, provided they receive appropriate clinical assessment from a registered UK prescriber and obtain the medicine through a GPhC-registered pharmacy. Private prescribing does not change the prescription-only status of these medicines or the need for appropriate clinical oversight.

What BMI qualifies for Wegovy on the NHS?

NICE TA875 specifies a BMI of ≥35 kg/m² with at least one weight-related comorbidity, or a BMI of ≥30 kg/m² with at least one weight-related comorbidity in specific higher-risk populations. Ethnicity-adjusted lower BMI thresholds apply for some ethnic groups (e.g., South Asian, Chinese, Black African/Caribbean — typically at BMI ≥27.5 or equivalent). The full criteria are in the NICE TA875 guidance.

What BMI qualifies for Mounjaro on the NHS?

NICE TA1026 specifies a BMI of ≥35 kg/m² with at least one weight-related comorbidity for Tier 3 settings, or BMI ≥30 to <35 kg/m² with at least one comorbidity in selected specialist pathways. As with TA875, ethnicity-adjusted thresholds apply. The full criteria are in the NICE TA1026 guidance.

Mounjaro vs Wegovy — NHS Access and NICE Eligibility Compared

Q: Is Mounjaro available on the NHS?

Mounjaro (tirzepatide) received a positive NICE technology appraisal (TA1026) for weight management in adults in England and Wales. NHS availability is subject to eligibility criteria including BMI thresholds, comorbidity requirements, and prescribing via an NHS Tier 3 specialist weight management service or equivalent specialist pathway.

Q: Is Wegovy available on the NHS?

Wegovy (semaglutide 2.4 mg subcutaneous) received a positive NICE technology appraisal (TA875) for chronic weight management in England and Wales. Like Mounjaro, it is prescribed via NHS Tier 3 weight management services or equivalent specialist pathways, subject to eligibility criteria.

Q: What is the difference between NHS and private prescribing for these medicines?

NHS prescribing requires meeting NICE eligibility criteria, referral through designated pathways (Tier 3 or specialist), and prescription within the NHS system. Private prescribing requires a valid prescription from a UK-registered prescriber following appropriate clinical assessment but is not constrained by NICE eligibility thresholds — the prescriber applies their own clinical judgement. Both routes require the medicine to be dispensed by a GPhC-registered pharmacy.

Mounjaro and Wegovy are both licensed in the UK for chronic weight management and both have positive NICE technology appraisals, but their eligibility criteria, prescribing pathways and commissioning contexts differ. This page compares the NHS access framework for each medicine. For the clinical evidence comparison, see semaglutide vs tirzepatide vs retatrutide.

Is Mounjaro available on the NHS?

Yes, subject to eligibility criteria. NICE TA1026 (published 2024) recommended tirzepatide (Mounjaro) as an option for managing overweight and obesity in adults within specialist NHS weight management services. The appraisal was positive on the basis that tirzepatide is cost-effective at the commercial price agreed with NHS England, conditional on use within the specified eligibility criteria and prescribing setting.

NHS availability is being implemented through NHS England commissioning arrangements and Integrated Care Systems. Waiting times and the rate at which Tier 3 services can expand to meet demand remain a practical constraint on access for many patients who are otherwise clinically eligible.

Is Wegovy available on the NHS?

Yes, subject to eligibility criteria. NICE TA875 (published 2023) recommended semaglutide 2.4 mg (Wegovy) as an option for chronic weight management in adults. Wegovy was the first weekly subcutaneous GLP-1 receptor agonist to receive a positive NICE obesity appraisal. NHS implementation has proceeded through designated specialist weight management services with the same Tier 3 pathway requirement as TA1026.

Supply constraints affected availability in the years following NICE approval; NHS England has issued commissioning guidance and prioritisation frameworks during periods of constrained global supply of semaglutide.

What does NICE TA875 say about Wegovy eligibility?

NICE TA875 specifies that semaglutide 2.4 mg is recommended only if all of the following criteria are met:

The person has a BMI of at least 35 kg/m² and at least one weight-related comorbidity; or a BMI in a lower range where an ethnicity-adjusted threshold applies and at least one comorbidity is present.
The person does not have type 1 diabetes.
Semaglutide is used as part of a specialist weight management service that provides multicomponent intervention including support with lifestyle, diet and physical activity, and psychological support.
Treatment is stopped at 104 weeks if the service criteria for continuing response are not met.

Ethnicity-adjusted BMI thresholds in TA875 acknowledge that equivalent cardiometabolic risk occurs at lower BMI in South Asian, Chinese and Black populations, and lower threshold ranges may apply — typically at BMI ≥27.5 kg/m² with comorbidities for some groups.

What does NICE TA1026 say about Mounjaro eligibility?

NICE TA1026 specifies that tirzepatide is recommended if all of the following apply:

BMI of at least 35 kg/m² with at least one weight-related comorbidity, in a Tier 3 or equivalent specialist setting; or BMI of 30 to below 35 kg/m² with at least one comorbidity in a specialist setting where access to the higher tier is unavailable.
The person does not have type 1 diabetes.
Tirzepatide is used as part of a specialist multidisciplinary weight management programme.
Treatment is reviewed at 52 weeks for clinical response and periodically thereafter.

Side-by-side eligibility comparison

Criterion	Wegovy (TA875)	Mounjaro (TA1026)
Primary BMI threshold	≥35 kg/m² + comorbidity	≥35 kg/m² + comorbidity
Lower BMI pathway	Ethnicity-adjusted (≥27.5 with comorbidity for some groups)	30–<35 kg/m² + comorbidity in specialist setting
Type 1 diabetes exclusion	Yes	Yes
Specialist service required	Yes — Tier 3 or equivalent	Yes — Tier 3 or equivalent
Review / stopping rule	Discontinue at 104 weeks if response criteria unmet	Review at 52 weeks; periodic review thereafter
NICE publication year	2023	2024

Who qualifies for NHS GLP-1 prescribing?

The common eligibility requirements across both TA875 and TA1026 can be summarised as: adults with obesity (BMI ≥35 kg/m² or lower with ethnicity adjustment) and at least one weight-related health condition, who do not have type 1 diabetes, and who are able to access care via an NHS specialist weight management pathway. Both appraisals are explicit that the medicines are to be used as part of a multicomponent programme — not as standalone pharmaceutical interventions.

Weight-related comorbidities referenced in both appraisals include type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea, and established cardiovascular disease, among others. The exact list and how comorbidities are scored may vary between commissioning frameworks.

Can I get Mounjaro or Wegovy privately if the NHS doesn't fund it?

Private prescribing is a lawful route to access these medicines for individuals who do not meet NHS eligibility criteria, who face waiting times for NHS pathways, or who prefer to access care outside the NHS. The requirements for private prescribing are: a valid prescription from a UK-registered prescriber following appropriate clinical assessment, and dispensing by a GPhC-registered pharmacy.

Private prescribing is not constrained by NICE eligibility thresholds, but responsible clinical practice still requires assessment of contraindications, comorbidities, current medications, BMI and relevant history. For guidance on verifying private online prescribing services, see online pharmacy safety and online pharmacy verification.

What's the difference between NHS and private prescribing for these medicines?

The key differences are eligibility constraints, prescribing pathway, cost to patient, and monitoring framework. NHS prescribing requires meeting NICE eligibility criteria and accessing the medicine via a Tier 3 service or equivalent, with structured follow-up included. Private prescribing requires a valid UK prescription following clinical assessment but is not constrained by NICE criteria; monitoring may be more variable depending on the service used.

From a pharmacological standpoint, the medicine dispensed is the same MHRA-licensed product regardless of NHS or private route — provided it is dispensed by a registered pharmacy.

Frequently asked questions

Is Mounjaro available on the NHS?: Mounjaro (tirzepatide) received a positive NICE technology appraisal (TA1026) for weight management in adults in England and Wales. NHS availability is subject to eligibility criteria including BMI thresholds, comorbidity requirements, and prescribing via an NHS Tier 3 specialist weight management service or equivalent specialist pathway.
Is Wegovy available on the NHS?: Wegovy (semaglutide 2.4 mg subcutaneous) received a positive NICE technology appraisal (TA875) for chronic weight management in England and Wales. Like Mounjaro, it is prescribed via NHS Tier 3 weight management services or equivalent specialist pathways, subject to eligibility criteria.
Do the NICE criteria apply in Scotland and Northern Ireland?: NICE technology appraisals apply in England and Wales. Scotland has its own process via the Scottish Medicines Consortium (SMC). Northern Ireland follows a distinct commissioning process. Access timelines and criteria may differ across the four nations.
What is a Tier 3 weight management service?: NHS Tier 3 services are specialist, multidisciplinary weight management programmes offering intensive lifestyle intervention, psychological support and medical input. NICE TA875 and TA1026 require that GLP-1 medicines are initiated and managed within such services or equivalent specialist pathways in most cases.
Can I get Mounjaro or Wegovy if I don't meet the NHS criteria?: Individuals who do not meet NHS criteria may explore private prescribing routes, provided they receive appropriate clinical assessment from a registered UK prescriber and obtain the medicine through a GPhC-registered pharmacy. Private prescribing does not change the prescription-only status of these medicines or the need for appropriate clinical oversight.
What BMI qualifies for Wegovy on the NHS?: NICE TA875 specifies a BMI of ≥35 kg/m² with at least one weight-related comorbidity, or a BMI of ≥30 kg/m² with at least one weight-related comorbidity in specific higher-risk populations. Ethnicity-adjusted lower BMI thresholds apply for some ethnic groups (e.g., South Asian, Chinese, Black African/Caribbean — typically at BMI ≥27.5 or equivalent). The full criteria are in the NICE TA875 guidance.
What BMI qualifies for Mounjaro on the NHS?: NICE TA1026 specifies a BMI of ≥35 kg/m² with at least one weight-related comorbidity for Tier 3 settings, or BMI ≥30 to <35 kg/m² with at least one comorbidity in selected specialist pathways. As with TA875, ethnicity-adjusted thresholds apply. The full criteria are in the NICE TA1026 guidance.
What is the difference between NHS and private prescribing for these medicines?: NHS prescribing requires meeting NICE eligibility criteria, referral through designated pathways (Tier 3 or specialist), and prescription within the NHS system. Private prescribing requires a valid prescription from a UK-registered prescriber following appropriate clinical assessment but is not constrained by NICE eligibility thresholds — the prescriber applies their own clinical judgement. Both routes require the medicine to be dispensed by a GPhC-registered pharmacy.

Mounjaro vs Wegovy — NHS access and NICE eligibility compared