NICE Endorses Lilly's Zepbound for Severely Obese Patients

The U.K.’s National Institute for Health and Care Excellence (NICE) recommended the use of Eli Lilly’s Zepbound (tirzepatide) for chronic weight management, to be used alongside dietary and lifestyle changes. This recommendation, announced on Tuesday, specifies that Zepbound should be used for individuals with a body mass index (BMI) of at least 35 kg/m² and at least one weight-related comorbidity. Furthermore, NICE advises discontinuing the treatment if patients do not achieve a minimum of 5% weight loss after six months.

NICE’s draft guidance highlights that clinical trial evidence shows tirzepatide combined with diet and exercise is more effective than diet and exercise alone. The guidance also hints that indirect comparisons suggest Zepbound might surpass Novo Nordisk’s Wegovy (semaglutide) in effectiveness.

Initially, Lilly proposed Zepbound for individuals with a BMI of 30 kg/m² or more. However, NICE argued that this proposal was not cost-effective based on their acceptable NHS resource use standards.

This endorsement for Zepbound follows NICE’s earlier support in late 2023 for its sister brand, Mounjaro, which is also used for type 2 diabetes. Mounjaro is recommended for patients with a BMI of at least 35 kg/m² and additional psychological or medical issues related to obesity. It is specifically indicated for patients for whom triple therapy, including metformin, has failed or is not suitable, and those for whom weight loss would bring significant health improvements.

Both Zepbound and Mounjaro are GLP-1 receptor agonists, which function by promoting insulin secretion from the pancreas in response to blood glucose levels and activating the GIP receptor, which assists in appetite regulation.

These treatments have rapidly become leading products for Eli Lilly. In the first quarter of 2024, the company reported nearly tripling Mounjaro's sales to $1.8 billion compared to the previous year. Despite Zepbound only gaining approval in November 2023, it still generated over $517 million in the first quarter.

The success of Zepbound is cementing Lilly's position in the competitive weight-loss drug market, where it contends with Novo Nordisk. Both companies have faced challenges in meeting the high demand for obesity treatments, but supply chains are now stabilizing. Market analysts predict the obesity drug market could reach a value of $150 billion by the early 2030s.

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