Analysis finds fewer than half of eligible patients in England can access Mounjaro on the NHS

Fewer than half of eligible patients in England are able to access the weight-loss drug Mounjaro on the NHS, a damning analysis published by the British Medical Journal (BMJ) has found, raising concerns about a postcode lottery in provision.

Health chiefs announced last year that millions of patients with obesity would be eligible for Mounjaro under a phased 12-year rollout. Since the programme began in June, the BMJ analysis shows that less than half of integrated care boards (ICBs) — the local commissioning bodies responsible for NHS services — have started prescribing the drug.

The BMJ’s data indicates wide variation between areas. Only nine ICBs reported they had the funding required to cover at least 70% of their eligible patients. Four ICBs, including Coventry and Warwickshire and Suffolk and North East Essex, said funding was sufficient for 25% or fewer of eligible patients. Five ICBs reported they were already considering tightening prescribing criteria further or rationing the treatment.

Mounjaro, a medicine that has been shown to help some patients lose significant weight, was highlighted by campaigners and clinicians as a potentially transformative option for people living with obesity. The BMJ report said thousands of people could miss out on the drug because local budgets are not aligned with projected need under the national rollout plan.

Professor Nicola Heslehurst, president of the Association for the Study of Obesity and a professor at Newcastle University, said the shortfall in funding was a further setback for people living with obesity. "The deficit in funding compared with need is another blow for people living with obesity, who deserve evidence-based care," she said.

The phased rollout was presented by health officials as a long-term plan to expand access gradually. The BMJ’s analysis, based on responses from ICBs and other publicly available data, suggests that the pace of adoption and the scale of local funding commitments vary markedly across England, producing what stakeholders described as unequal access depending on where patients live.

NHS decision-makers have pointed to competing budgetary pressures and the need to set local commissioning priorities. Some ICBs that have not yet started prescribing said they were assessing clinical criteria, supply arrangements and budget impacts before rolling out Mounjaro services more widely.

Clinicians and patient groups have said that inconsistent local provision could undermine the intended equity of the national programme and delay treatment for people at high risk from obesity-related conditions. The BMJ analysis underscores the gap between the national intent to offer Mounjaro to millions over time and the current capacity of local health systems to fund and deliver the treatment.

The report follows weeks of public debate over the use of GLP-1 receptor agonists such as Mounjaro for weight management and their integration into NHS services. The BMJ analysis will fuel calls from campaigners and some clinicians for clearer national funding commitments or additional central support to ensure more consistent access across England.

The BMJ report and responses from ICBs provide a snapshot of the rollout’s early months; local officials and national bodies will face pressure to set out how and when access will reach the levels envisaged in the phased plan.