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Tirzepatide not recommended in latest NICE diabetes guidance

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Tirzepatide not recommended in latest NICE diabetes guidance

More evidence is needed on the clinical and cost-effectiveness of tirzepatide, a new treatment option for people with type 2 diabetes, before it can be recommended for NHS use, says NICE.

Tirzepatide (Mounjaro, Eli Lilly), has not been recommended in draft guidance issued by NICE on 27 June for treating type 2 diabetes in adults alongside diet and exercise.

Tirzepatide is taken weekly by injection. Lilly has positioned it as an option later in the treatment pathway as an alternative to glucagon-like peptide 1 (GLP-1) receptor agonists such as dulaglutide, liraglutide and semaglutide which are already recommended for use in the NHS.

An independent NICE committee recognised the importance of new treatment options given that fewer than two-thirds of the adults with type 2 diabetes have adequate glucose control when using current treatment options.

Evidence submitted to the committee from clinical trials showed the use of tirzepatide at any dose resulted in better glucose control and lower weight compared with semaglutide or insulin therapy.

The weight reduction was more pronounced with higher doses of tirzepatide, while the effect on glucose levels seemed less dose-dependent. Similar effects were observed against all GLP-1 receptor agonists in company’s network meta-analysis, but this was uncertain.

Lilly has been asked to provide more data to address the uncertainties in the clinical evidence, when compared to all relevant alternative treatments.

The long-term health benefits of tirzepatide compared with other GPL-1 receptor agonists are also unclear, so it is yet to be established if it represents good value for money, says NICE.

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