Mounjaro expanded to include weight management

GPs can now prescribe tirzepatide (sold as Mounjaro) to eligible patients as a treatment for overweight and obesity.

Mounjaro is already indicated for the treatment of adults with insufficiently controlled type 2 diabetes, as an adjunct to diet and exercise.
 
But a Therapeutic Goods Administration (TGA) decision on Tuesday means the medication is now indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management, including weight loss and weight maintenance.
 
It is eligible to adults with an initial body mass index (BMI) of ≥30 kg/m2 or ≥27 kg/m2 in the presence of at least one weight-related comorbid condition, such as hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, pre-diabetes or type 2 diabetes.
 
The change follows the registration of a new delivery device, the Mounjaro KwikPen, earlier this year.
 
The tirzepatide solution for injection vial remains in shortage and is expected to stay that way until August next year, with demand for weight loss drugs showing no signs of slowing down.
 
‘To improve the supply situation, Eli Lilly Australia (Lilly) has commenced a transition period in which Mounjaro (tirzepatide) single-use vials will be replaced with Mounjaro (tirzepatide) multi-use KwikPen,’ the company said.
 
‘Lilly is committed to ongoing replenishment of all doses of the Mounjaro KwikPen presentation.’
 
Dr Gary Deed, Chair of RACGP Specific Interests Diabetes welcomed the expansion, but added that any agent should be part of a multidisciplinary approach which also includes lifestyle advice.
 
‘It won’t suit everyone, and that’s where a really good GP provides the key anchoring point for patients to open the conversation of managing weight, but also giving them support to see what’s appropriate,’ he told newsGP.
 
‘Some people might need a psychologist, other people might need an accredited practising dietitian, other people might need an exercise physiologist, and some people need all of those.
 
‘For GPs, it really allows you to get a valuable tool that is part of the modern approach to supporting people who are overweight [or] obese.’
 
Eli Lilly Australia confirmed it is on track to meet increased global production targets for its incretin medicines, including Mounjaro, amid a global shortage of weight loss medications.
 
It said its global production in the second half of 2024 will be increasing by at least 150% compared to the second half of 2023.
 
Eli Lilly Australia general manager Tori Brown said the company continues to do everything it can to ensure adequate supply of Mounjaro in Australia.
 
‘Consistent supply of essential medicines to patients is our company’s highest priority,’ she said.
 
As of October, compounding pharmacies were banned from producing replicas of Ozempic and Mounjaro as demand for the social-media-famous-drugs continues.
 
Last month, Wegovy was launched in Australia for the first time, making it the latest semaglutide drug specifically targeted for weight loss to hit the market.

The addition was welcomed, but the launch was met with significant concern and scepticism from GPs amid the worldwide critical shortages of Ozempic.
 
Mounjaro is still only available on private prescription, not through the Pharmaceutical Benefits Scheme (PBS), and its recommended private prescription price begins at $395 per month for the initiation dose.
 
Dr Deed said he is still seeing patients everyday expressing interest in weight loss medications, and that a high price may not be a deterrent for some.
 
‘It is quite expensive, but GPs need to include discussion about the price of these things, and I think the take-home message to us is never assume someone doesn’t want to invest in their health,’ he said.
 
‘GPs play a big role in giving very practical and sound advice to patients who might have a distorted view that taking the drug alone is the holy grail, in fact, they only work in conjunction with appropriate, supportive multidisciplinary care.
 
‘There will be concerns about supply if prescribing suddenly explodes, and anything’s possible, but having two options might take the pressure off supply of both injectable agents.’
 
Mounjaro is set to be reconsidered for PBS reimbursement for the treatment of type 2 diabetes in November this year.
 
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diabetes loss Mounjaro overweight and obesity Ozempic semaglutide tirzepatide weight