Encyclopedia entry

NICE TA1026

NICE Technology Appraisal 1026 was published in December 2024. It is the UK authoritative document governing tirzepatide (Mounjaro) availability through NHS England for weight management. It defines the BMI thresholds, comorbidity requirements, ethnicity-adjusted thresholds, the phased cohort rollout, and the criteria for continuation or discontinuation.

Headline eligibility framework

Cohorts defined by BMI and comorbidity count, rolling out over a period of up to 12 years. Cohort 1 (highest severity) live since June 2025. Cohort 2 launches 23 June 2026. Beyond June 2026, eligibility extends progressively in later phases, prioritised by clinical need; the criteria and timing for those later cohorts have not yet been finalised by NHS England. Ethnicity-adjusted thresholds (2.5 kg/m² downward) apply throughout.

Comorbidities that count

• · Type 2 diabetes.
• · Hypertension.
• · Dyslipidaemia (raised total cholesterol, raised LDL, or raised triglycerides).
• · Obstructive sleep apnoea.
• · Cardiovascular disease (ischaemic heart disease, heart failure, established stroke risk).

Continuation and discontinuation criteria

NICE TA1026 specifies that NHS continuation of tirzepatide requires 5 percent weight loss from baseline by month 6 (the "stopping rule"). Patients not meeting that threshold should have continuation reviewed against the clinical benefits and risks (per NICE TA1026). This rule does not apply to private prescribing; private patients and prescribers set their own continuation criteria.

Why TA1026 is structured around weight management rather than diabetes

Tirzepatide was first NHS-approved for type 2 diabetes in 2023 under a separate technology appraisal (TA875). TA1026 is the weight-management appraisal, distinct from the diabetes pathway. A patient may qualify for tirzepatide on the diabetes pathway with different criteria from the weight-management pathway. The two pathways are commissioned separately by ICBs.

Related: NHS GLP-1 access · ethnicity-adjusted BMI · ICB rollout tracker.