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GPs will continue to be blocked from prescribing new weight-loss drugs by the Welsh Government because NHS Wales is not ready for the huge demand.

Around 186,000 people in Wales are estimated to be eligible for tirzepatide (Mounjaro) alone, which has been approved by the National Institute for Health and Care Excellence (NICE) for managing obesity.

But because the Welsh NHS cannot handle this level of demand, the rollout is being paused while a new “clinical pathway” is developed to build capacity.

An interim rule has been introduced and prescriptions must only be made by specialist weight management services. An exception exists for a small number of high-need patients who, for example, have cancer, need a transplant or are in the care of fertility services.

Sioned Rees, director of public health, and Andrew Evans, the Welsh Government’s chief pharmaceutical officer, issued an update to health boards today (October 23).

The specialist-only rule also applies to semaglutide (Wegovy) and liraglutide (Saxenda), two other weight-loss drugs, with a global surge in demand far outstripping supply.

‘New model’

Anyone already receiving these drugs on the NHS before the circular was published can continue their treatment and will not have their prescriptions stopped. The update does not apply to prescribing tirzepatide for its other licensed uses.

Welsh Government officials wrote: “The new model will include the development of a clinical pathway with the aims of treating and managing obesity as a chronic, recurring condition and to support equitable access to weight-loss drugs and associated wrap-around support.”

NICE usually requires a new drug to be available within two months but granted an exemption, extending the implementation period to up to 12 years, in recognition of the potentially very large eligible cohort.

The officials wrote: “We appreciate considerable demand for specialist weight management services and a growing pressure for access to these medications through the NHS.

“The work being undertaken to develop a new clinical pathway will support building capacity and capability across Wales across specialist, primary care and community settings.

“These pathways will ensure tirzepatide and other weight-loss medications can be made available in the NHS in Wales in a seamless, equitable, safe and effective way.”