Field-state assessment
February 2026: Where the incretin class stands at the start of 2026
January → February 2026 brief: A field-state assessment as the new year opens — three MHRA-licensed compounds, two Phase 3 programmes pending, retatrutide approaches its first Phase 3 readout.
Three MHRA-licensed compounds
As 2026 opens, the UK metabolic peptide field has three MHRA-licensed prescription compounds in regular use: tirzepatide (Mounjaro), semaglutide (Ozempic / Wegovy / Rybelsus), and liraglutide (Saxenda / Victoza). The class has matured from a single MHRA-licensed monoagonist five years ago to a tiered set spanning daily → weekly dosing, monoagonist → dual agonist, T2DM → weight management → cardiovascular prevention.
Two Phase 3 programmes pending
The next 18 months are dominated by two outstanding Phase 3 programmes. Retatrutide's TRIUMPH-1 in obesity (expected H1 2026) tests whether the Phase 2 ~24% weight reduction scales to a larger registrational cohort. Tirzepatide's SURMOUNT-MMO and SURPASS-CVOT (late 2026) test whether the dual-agonist class delivers a SELECT-like cardiovascular benefit. Both read-outs will reshape the field.
The research-only tier
Outside the MHRA-licensed group, research-grade material continues to circulate for laboratory work on retatrutide, tesamorelin, CJC-1295 / ipamorelin, AOD-9604 and HGH Fragment 176-191. None are approved for human therapeutic use in the UK. The MHRA position remains unchanged from 2025: research peptides are not medicines, are supplied for laboratory and analytical use only, and must not be administered to humans outside formal clinical-trial settings — see the the UK regulatory picture across all nine topics for the full breakdown of prescription-only, investigational and research-only categories.
UK access pathways
Three pathways now dominate UK clinical access to the licensed class: NHS specialist weight-management services (capped capacity, ~12-month referral waits in most regions), private prescriber networks (rapid access, full private cost), and pharmacy-led services (limited to specific indications and BMI thresholds). The mix of these three channels — and the implicit rationing — has become the defining UK-specific feature of the licensed incretin class.
What to watch in 2026
Three things. First, TRIUMPH-1 readout (H1). Second, SURMOUNT-MMO interim (mid-year). Third, NICE's response to the SELECT cardiovascular signal — guidance is overdue. We'll cover each in the monthly briefs.