Presentation (CTI)

OBJECTIVES: As of the most recent Health Survey for England in 2022, 64% of adults were overweight or living with obesity. In England, tirzepatide and orlistat are available for weight management through the NHS. Tirzepatide was approved as an option for weight management in December 2024. Integrated Care Boards (ICBs) are legally responsible for funding and managing the phased, local rollout of tirzepatide. Little is known about the variation of implementation of Tirzepatide guidance across ICBs. Understanding variation in uptake of weight medications may help identify inequities in access. We aimed to describe how tirzepatide prescribing by General Practitioners in England has changed over time, and how it varies across ICBs. Describe how tirzepatide prescribing varies by obesity rate and describe the changes in orlistat prescribing following the introduction of tirzepatide.
METHODS: We conducted an observational descriptive study using prescribing data from all NHS general practices in England between January 2023 and December 2025. We analysed monthly time trends of prescribing for tirzepatide and orlistat. We used descriptive plots to show i) prescribing rates over time ii) the variation of prescribing rates within ICBs.
RESULTS: In December 2025 the prescribing rate per 1000 registered patients of tirzepatide by ICBs ranged from 8.8 (NHS Cornwall and the Isles of Scilly) to 1.36 (NHS Dorset). The most commonly prescribed strength of tirzepatide was 5mg/0.6ml. The corresponding prescribing rate per 1000 registered patients of orlistat ranged from 1.31 (NHS Black Country) to 0.054 per 1000 (NHS Northamptonshire).
CONCLUSIONS: We found consistent variation in prescribing rates of both tirzepatide and orlistat at ICB and regional level. We found similar levels of variation when accounting for the QOF obesity register list size. The prescribing rate of orlistat does not appear to have meaningfully changed since the introduction of tirzepatide.