This guide explains NICE TA1026 for patients: what it is, who it recommends tirzepatide for, the phased NHS rollout, the six-month review, and how this fits with the private route. It draws on NICE and the NHS. Eligibility rules and the rollout timetable can change, so check the current NICE guidance and your local service for the latest position.
What is NICE TA1026?
TA1026 is a NICE technology appraisal, the formal guidance that determines whether the NHS in England funds a treatment and for whom 1. This one covers tirzepatide (brand name Mounjaro) for managing overweight and obesity in adults, and it was published in December 2024 and last updated in September 2025 1.
When NICE recommends a treatment in a technology appraisal, the NHS in England is generally required to fund it for the group described, which is why TA1026 matters so much for access 1. It is the document that turns 'licensed' into 'available on the NHS' for defined patients 1.
So when people ask about 'Mounjaro on the NHS', TA1026 is the source of the answer, alongside the NHS England implementation arrangements that phase it in 1. The sections below set out the criteria and the rollout 1.
It helps to know that a NICE technology appraisal is different from the medicine's licence 1. The licence (the SmPC) defines who the medicine can be prescribed to in principle, while TA1026 defines the narrower group the NHS in England will fund it for, which is why some people fall within the licence but not within the NHS criteria 1. That distinction is the key to understanding why 'available privately' and 'funded on the NHS' are not the same thing, and why the NICE criteria matter so much for access 1.
Who NICE recommends it for
TA1026 recommends tirzepatide, alongside a reduced-calorie diet and increased physical activity, only for adults who have an initial BMI of at least 35 kg/m2 and at least one weight-related comorbidity, and where the company provides it under the agreed commercial arrangement 1. So it is targeted rather than open to everyone with excess weight 1.
Importantly, a lower BMI threshold (usually reduced by 2.5 kg/m2) applies for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds, because weight-related health risks can occur at a lower BMI 1. So the BMI figures are adjusted for ethnicity 1.
NICE specifically did not recommend tirzepatide for the wider group with a BMI of 30 or above and one comorbidity, because the cost-effectiveness for that group was outside the range NICE considers acceptable, which is why the threshold sits at 35 1. The weight-related conditions that count include high blood pressure, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease and type 2 diabetes 1.
The phased NHS rollout
Because demand is large, NHS England is introducing tirzepatide in phases under a funding variation, so meeting the NICE criteria does not necessarily mean you can access it immediately 1. Eligibility in the rollout depends on your BMI and how many of the listed weight-related conditions you have 1.
Under the published timetable, you may be eligible now with 4 or more of the listed conditions and a BMI of 40 or more; from around June 2026 with 4 or more conditions and a BMI between 35 and 39.9; and from around March 2027 with 3 of the conditions and a BMI of 40 or more1. For the ethnic backgrounds noted above, the qualifying BMIs are 2.5 lower (for example 37.5 instead of 40) 1.
So the practical reality is that access is widening over time, and where you sit depends on both your BMI and your number of conditions 1. This timetable can change, so the current NICE guidance and NHS England arrangements are the place to check the latest position 1.
The reason for the phasing is straightforward: the number of people who meet the criteria is very large, and introducing the medicine to everyone at once is not practical for the NHS, so it is being rolled out to those with the highest BMI and most weight-related conditions first 1. That means two people who both meet the headline NICE criteria can still be at different points in the queue depending on their exact BMI and number of conditions 1. Understanding this avoids the confusion of meeting the criteria on paper but finding the rollout has not yet reached your group 1.
Considering treatment for weight management? You can start an assessment with a Cloud Pharmacy clinician, who will review your medical history and confirm whether treatment is appropriate.
The six-month review
TA1026 builds in a review at six months: if less than 5 percent of initial weight has been lost on the highest tolerated dose, a decision is made on whether to continue, taking into account the benefits and risks for the individual 1. So NHS treatment is not open-ended; it is reviewed against a clear marker 1.
This 5 percent at six months is a review threshold, a point at which prescriber and patient assess whether the treatment is working well enough to continue, not a cap on what is possible 1. It mirrors the checkpoint in the medicine's licence 1.
The guidance also notes it does not affect people who started tirzepatide on the NHS before TA1026 was published, who may continue under their previous funding arrangements until they and their clinician decide otherwise 1.
It is worth seeing the six-month review as a sensible checkpoint rather than a hurdle to fear 1. It exists so that treatment continues for people it is genuinely helping and is reconsidered where it is not, which is a reasonable use of a treatment that has to be funded carefully 1. In the trials, most people reached the 5 percent mark comfortably, so for many the review is a confirmation that things are on track rather than a cliff-edge 1.
Primary care, specialist services and semaglutide
A notable point in TA1026 is that tirzepatide can be used in primary care or in specialist weight management services1. This differs from semaglutide (Wegovy) under its own NICE guidance, which is recommended within a specialist weight management service 1.
NICE's appraisal also found, from clinical trial evidence, that tirzepatide with diet and exercise support is more effective than diet and exercise alone, and that indirect comparisons suggest it is more effective than semaglutide alongside diet and exercise support 1. This is NICE's appraisal finding, presented here as information rather than a recommendation of one medicine over another for you 1.
Which treatment, route and service apply to you is a clinical decision, and the NHS confirms you are only prescribed it if you meet the eligibility criteria after the appropriate assessment 2. Our guide on how to choose a weight-loss treatment covers the wider picture 2. The point of including NICE's effectiveness finding here is information, not a steer towards one medicine, since which is right for you depends on far more than a trial average and is for your prescriber to judge 12.
What this means for you
In practice, if you think you meet the criteria, the route is to speak to your GP or NHS service about eligibility and the current phase of the rollout 12. Knowing your BMI and your weight-related conditions before that conversation helps, remembering the lower thresholds for some ethnic backgrounds 1.
If you do not yet meet the NHS criteria, or the rollout has not reached your group, some people consider a private prescription, which follows the medicine's broader licence rather than the narrower NICE NHS criteria 12. If you go private, the NHS stresses buying from a registered pharmacy, because some websites sell fake weight-loss medicines 2.
Because the criteria and rollout can change, check the current NICE guidance and your local NHS service for the latest position rather than relying on a fixed snapshot 1. Our guide on how Mounjaro works covers the medicine itself 1.
Frequently asked questions
What is NICE TA1026?
It is the NICE technology appraisal that lets the NHS in England fund tirzepatide (Mounjaro) for managing overweight and obesity in adults, published in December 2024 and last updated in September 2025 1. It sets out who qualifies and on what terms, which is the basis for getting Mounjaro on the NHS 1.Who qualifies for Mounjaro on the NHS under TA1026?
Adults with an initial BMI of at least 35 and at least one weight-related comorbidity, alongside diet and activity, with lower BMI thresholds (usually 2.5 lower) for several ethnic backgrounds 1. Access is phased by BMI and number of conditions, so meeting the criteria does not always mean immediate access 1.How is NHS tirzepatide being phased in?
Under the published timetable, you may be eligible now with 4 or more listed conditions and a BMI of 40 or more; from around June 2026 with 4 or more conditions and a BMI of 35 to 39.9; and from around March 2027 with 3 conditions and a BMI of 40 or more 1. Ethnic-adjusted BMIs are 2.5 lower, and the timetable can change 1.What is the six-month review in TA1026?
If less than 5 percent of initial weight has been lost on the highest tolerated dose after six months, a decision is made on whether to continue, weighing the benefits and risks for the individual 1. It is a review threshold rather than a cap, mirroring the checkpoint in the medicine's licence 1.Can my GP prescribe tirzepatide under TA1026?
TA1026 allows tirzepatide to be used in primary care or specialist weight management services, which differs from semaglutide's specialist-service route 1. You are prescribed it only if you meet the eligibility criteria after the appropriate assessment 2. Speak to your GP or NHS service about your eligibility and the current phase 12.What if I do not meet the NHS criteria for Mounjaro?
Some people consider a private prescription, which follows the medicine's broader licence rather than the narrower NICE NHS criteria 12. If you go private, the NHS stresses buying from a registered pharmacy because some websites sell fake weight-loss medicines 2. Check the current NICE guidance and your local service, as the rollout can change 1.Your next step
NICE TA1026 is the guidance that lets the NHS in England fund tirzepatide for weight management, recommending it alongside diet and activity for adults with a BMI of at least 35 and at least one weight-related condition, with lower thresholds for several ethnic backgrounds. Access is being phased in by BMI and number of conditions over three years, and treatment is reviewed at six months against a 5 percent marker.
If you think you qualify, speak to your GP or NHS service about your eligibility and the current phase of the rollout, knowing your BMI and weight-related conditions beforehand. If you do not yet qualify, a private prescription from a registered pharmacy is an alternative. Check the current NICE guidance and your local service, as the criteria and timetable can change. Knowing your BMI, your weight-related conditions and which phase of the rollout you fall into puts you in the best position to have that conversation, and remembering that 'licensed' and 'funded on the NHS' are not the same thing helps set realistic expectations.
Disclaimer
This guide is for general information only and does not constitute medical advice, diagnosis or treatment. The information here describes general clinical context based on UK regulatory sources cited above; it is not a recommendation for any specific medicine or treatment, which can only be made by a prescriber following individual assessment.
If you are considering treatment, speak to your GP or pharmacist, or arrange a consultation with a Cloud Pharmacy clinician. Prescription-only medicines are issued only after clinical assessment and where appropriate.
If you experience side effects from any medicine, you can report them through the Yellow Card scheme at yellowcard.mhra.gov.uk.
