GLP-1 Treatments
Updated April 2026

Mounjaro on the NHS 2026:
QOF Update Explained

What the QOF 2026/27 inclusion means for tirzepatide prescribing, who is eligible, how to get Mounjaro through the NHS and how it differs from going private.

Key points

  • QOF 2026/27: Updated indicators for obesity and type 2 diabetes recognise GLP-1 and dual GIP/GLP-1 agonists like tirzepatide
  • NHS availability: Mounjaro is available on the NHS for type 2 diabetes (GP prescribing) and weight management (Tier 3 specialist services)
  • GP prescribing: GPs can now prescribe Mounjaro for type 2 diabetes in primary care, supported by updated QOF incentives
  • Weight management: Requires referral to specialist Tier 3 services, similar to Wegovy
  • Clinical evidence: Average weight loss of 20–22% at maximum dose in clinical trials

What is the QOF and why does it matter?

The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme for GP practices in England. It sets out clinical indicators that practices are expected to meet, covering areas such as diabetes management, cardiovascular disease prevention and chronic disease monitoring. GPs receive funding linked to their performance against these indicators.

The QOF 2026/27 update is significant for patients interested in Mounjaro because it includes updated indicators that specifically recognise the role of GLP-1 receptor agonists and dual GIP/GLP-1 agonists (such as tirzepatide) in the management of type 2 diabetes and obesity. This gives GP practices a stronger incentive to consider these medications for eligible patients, potentially facilitating earlier prescribing in primary care.

What this means in practice: The QOF update does not automatically entitle every patient to Mounjaro. It creates a framework in which GPs are encouraged to review their patients with type 2 diabetes and obesity, consider whether a GLP-1 or dual agonist is appropriate, and initiate treatment where NICE criteria are met. It removes some of the previous hesitancy around prescribing these newer medications in primary care.

Two NHS pathways for Mounjaro

Mounjaro is available on the NHS through two distinct pathways, depending on the primary treatment goal.

Pathway 1: Type 2 diabetes (GP prescribing)

For patients with type 2 diabetes, Mounjaro can be prescribed directly by GPs in primary care. The QOF 2026/27 update supports this by including tirzepatide within the diabetes management indicators. To be eligible, patients typically need to meet the following NICE criteria:

This pathway is more straightforward than the weight management route, as it does not require referral to a specialist service. Your GP can initiate and manage the prescription in primary care.

Pathway 2: Weight management (Tier 3 specialist services)

For patients whose primary goal is weight management (with or without type 2 diabetes), Mounjaro is available through NHS Tier 3 specialist weight management services. The eligibility criteria and referral process are similar to those for Wegovy on the NHS:

QOF 2026/27: what has actually changed?

The specific changes in the QOF 2026/27 framework relevant to Mounjaro include:

Updated diabetes indicators

What this means for GP practices

These indicators incentivise GP practices to actively review patients who might benefit from tirzepatide, rather than waiting for patients to request it. Practices that achieve higher scores on these indicators receive additional QOF funding, creating a financial incentive alongside the clinical rationale.

Important distinction: The QOF indicators encourage review and consideration of these medications, but they do not mandate prescribing. The final decision about whether Mounjaro is appropriate for any individual patient remains a clinical judgement made by the prescriber in discussion with the patient.

Mounjaro NHS vs private: key differences

Factor NHS Private
Cost to patient £9.90 per prescription item (England) or free (Scotland/Wales/NI) £180–£350 per month
Waiting time Diabetes: minimal (GP appointment). Weight management: weeks to 12+ months for Tier 3 Days to 1–2 weeks
Eligibility criteria Must meet NICE criteria Clinical assessment by provider; generally less restrictive
Clinical oversight GP (diabetes) or specialist team (weight management) Varies by provider (see clinics guide)
Behavioural support Structured programme included (Tier 3) Varies: some providers include, some do not
Dose choice Full range (2.5–15 mg) Full range (2.5–15 mg)

How to ask your GP about Mounjaro

If you believe you may be eligible for Mounjaro on the NHS, the following approach may be helpful:

  1. Book a GP appointment specifically to discuss your weight and/or diabetes management
  2. Come prepared with your recent blood test results (if available), a list of current medications and your weight history
  3. Mention the QOF update — some GPs may not yet be fully aware of the updated indicators. You can reference the QOF 2026/27 obesity and diabetes indicators
  4. Ask specifically whether tirzepatide might be appropriate for you, based on NICE guidance
  5. Be open to discussion — your GP may suggest alternative treatments if Mounjaro is not the best fit, such as Ozempic for diabetes or Wegovy for weight management

Timeline: when will Mounjaro be widely available on the NHS?

Mounjaro is already available on the NHS, but the practical rollout has been gradual. The following timeline summarises key milestones:

The QOF update is expected to accelerate uptake in primary care throughout 2026 and 2027, particularly for patients with type 2 diabetes who have not yet been reviewed for GLP-1 or dual agonist therapy.

Mounjaro vs Wegovy on the NHS

Both Mounjaro and Wegovy are available through NHS Tier 3 services for weight management. The choice between them depends on clinical factors:

For a full comparison, see our Ozempic vs Wegovy vs Mounjaro comparison.

Frequently asked questions

Does the QOF update mean my GP has to prescribe Mounjaro?

No. The QOF indicators encourage GPs to review patients who might benefit from GLP-1 or dual agonist therapy, but they do not mandate prescribing. The decision remains a clinical judgement based on individual patient circumstances, NICE guidance and local prescribing policies.

Can I get Mounjaro for weight loss from my GP?

For weight management, Mounjaro must be initiated through a Tier 3 specialist weight management service, not directly from your GP. However, for type 2 diabetes, your GP can prescribe Mounjaro directly. If you do not have type 2 diabetes and want Mounjaro for weight management, you will need a Tier 3 referral or a private prescription.

Is Mounjaro better than Ozempic?

Head-to-head trial data (SURPASS-2) showed that tirzepatide produced greater reductions in HbA1c and body weight than semaglutide 1 mg. However, no direct comparison with higher-dose semaglutide (Wegovy 2.4 mg) has been completed. Whether Mounjaro is better for you depends on your diagnosis, treatment goals and clinical circumstances. See our Ozempic vs Wegovy and full comparison guides.

How much does Mounjaro cost on the NHS?

You pay the standard NHS prescription charge: £9.90 per item in England (as of April 2026), or free with a valid exemption or prepayment certificate. Prescriptions are free in Scotland, Wales and Northern Ireland.

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