Extremely hacked off by GP. Won’t prescribe Mounjaro

[Hakunatomato]

I have been self funding Mounjaro for the past year, and have a debt on credit card because of it. As a result, my HBa1c has gone from 19 to 5.5. I have lost almost 5 stones, now down to 16 .stones so effectively I have put my diabetes into remission as a result. I can no longer afford it because of the price rises and have asked my GP to start prescribing it. Their response is that because my blood sugar is now nearly normal they won’t do it, despite me having a bmi of 46. When I finish the course I have I now have to watch my good work go in to reverse and watch my health decline. All for the sake of the £30 a week is would cost my GP at wholesale NHS cost. If I put the weight back on again and wait while my blood sugar levels rise and I will have to apply again. I am so pissed off.. The relatively small cost as opposed to what the bills will be when my Diabetes returns doesn’t make sense.

How much were you spending on MJ yourself before now? Could you be proactive and spend that amount on something like a personal trainer to start lifting weights and building lean muscle? Ultimately that will help you more in the long term with blood sugar management.
Join a local walking group? Ask for a referral to weight management services? Regularly see your practice nurse for weigh ins / support? Pre plan all your meals and get the shopping delivered to remove temptations?

Essentially, you need to keep going with the momentum you've built up and find ways to keep going under your own steam, not blame the GP and take the stance of complete acceptance that you will fall back into bad habits. You have a choice in the matter.

You're comparing weekly any monthly for a start - and the monthly costs are not as high as the advertised £300. But, lets compare apples and apples.

NHS: £30 (speculated as this figure is not available publicly)
Private £70 per week (based on your £300 assumption).

This. ^

We do. We’re not stupid and plan for all eventualities. If I were doing something, an accident occurred, I’d expect to be assisted in every way I can and the NHS doesn’t provide the level of care and help required - especially for rehab. You need insurance otherwise you’ll never recover.

So how’s your argument for a line must be drawn somewhere? The line is for people who get themselves into stupid situations without a back up plan. OP lost and is finding out the hard way.

If the price is going up the NHS will also be paying a higher price.

The way the wholesale system for medication in this country works there isn't really a way to give those on the NHS a cheaper price. Unless supply to paitents is made directly via hospitals (as they can have individual contracts with suppliers). The stock is ordered from the same suppliers at the same cost regardless of whether the item is being given via an NHS prescription or a private prescription.

Plus it certainly costs the NHS more than the list price of the item for a paitent to have it. GP'S, surgery staff, pharmacists and pharmacy staff also need to be paid. It would cost the NHS more than £30 a week to supply.

Not even 50 yrs ago…the upwards trajectory took off in the ‘90’s. really evident in healthcare the last couple of decades.

I would suggest contacting your MP, and also Wes Streeting as health minister. There must be many people in your position and it would help to put make the government aware of the depth of feeling. Cutting people off from medication may well be a false economy (and I suspect it’s may be as much to do with supply issues too).

I’s also recommend checking out Dr Emma Anders on YouTube. She’s an obesity specialist on Mountjaro Hersey - unlike many of the ignorant commenters on here, she understands the many potential factors behind obesity, the risks of weight-cycling, etc. Lots of good advice and encouragement - also warns against split-dosing, micro-dosing, interval stretching, and all the other things people are considering to save money.

Good luck - and congratulations on your weight loss so far!

Was it meant to be a lifetime drug?

Your GP is irreponsible for not prescribing something they aren't allowed to prescibe, but you are responsible because you ran up a credit card debt to purchase a drug that you could not afford?

Read the book ultra processed people. It is frightening how ultra processed food is altering peoples bodies and is driving up obesity rates. The consumption of UPF and obesity are highly correlated. Obese mothers during pregnancy are potentially altering their child’s epigenetics meaning they are much more likely to be obese themselves, which further drives up rates. Consumption of refined sugars and carbs alter the bodies ability to respond to insulin and so on and so on it goes. An epidemic is the right word.

The prescribing limits on MJ are nothing to do with need or clinical suitability and everything to do with costs. There is an element of self control and habit building of course - but MJ can help with that and set the correct conditions for success. So OP I think you have every right to be pissed off but also after a year should have embedded better habits, weaned off sugar and refined carbs and hopefully taken up exercise that perhaps wasn’t possible due to your original size. I say this as someone who has taken MJ privately and it has hugely helped me with a sugar addiction and what I suspect was peri insulin resistance.

I probably will, I’ve had a 2mm reduction in the size of my worst fibroid since I started taking it, as well as dropping 12kg so far. The effects on my health and wellbeing are worth it and I’m lucky I can absorb the cost increases (at the moment)

Agree with everyone asking what your long term plan is? At some point, you (and everyone taking GLP-1 type drugs) will need to come off them and transfer into lifestyle measures. These drugs surely cannot be a ‘for life’ treatment?

On pricing, they will get cheaper only when generics become available and that won’t be for years. When you buy a drug you are really paying for the many many years of research (15+) that it take to get a drug to market, plus the costs of programmes that didn’t make it. The chemicals are the cheap bit.

Global companies also charge by market - this means not all countries pay the same. Thanks to the good old US of A, a lot of drugs are about to get a lot more expensive for us.

Stop with the hyperbole. No medical professional is “condoning” you to become unhealthy again; that is a choice you make. At this point you can give up (as you seem to have already decided) or keep going. That choice is yours and yours alone.

As you know, losing weight is not easy and the WLI (like all diets) are there to help you learn new habits. Thing is, we are humans and it takes a lot of self discipline to maintain those habits (I know this only too well). You have got to focus and keep up the discipline. Has your Dr’s got a weight loss group you could join (where I am there is a programme/group called Chrysallis that you self refer to) to help with accountability? If not, would a wright loss group help you be accountable to yourself? What about friends and family- aren’t they proud of what you’ve achieved - I’m sure they’d help, support and motivate you.

Doesn’t matter how many years you’ve worked or how much NI you’ve paid, it isn’t your own private fund to draw down when you want. Stop acting like a spoilt child. If you met the conditions your GP would prescribe, but as it stands you are not eligible for NHS help. No point being angry. Get out of the negative/woe is me mindset and focus on how far you’ve come and keep going.

Car culture has a lot to do with it, of course, but our food today is more processed, contains more additives, more things like corn syrups… perhaps in future we’ll find that our gut biome - or the enzymes and hormones that we use in our digestion - have become disrupted by things like MSG, preservatives, sweeteners, E numbers etc.

It’s a feminist issue bc it’s a tall order to shop local and cook from scratch when you’re raising a family in a time when kids no longer ‘play together in the street until teatime’ and you’re also holding down a full time job.

With a bmi of 46, you will still be able to eat quite a lot and lose weight so it should be very doable to keep losing at this stage without MJ.

I do think the NHS should look at the bigger picture though. If you stay at this weight or put on more, the cost to them will be much more than £30 a week in the not too distant future.

WLI don't 'retrain your mind'. I have no idea where you've got this from but it's completely wrong. You actually do know nothing about WLI.

There’s truth in this. Ive gone through periods of overeating/secret eating/bulimia/anorexia. Often influenced by life stresses in one way or another. My mother’s relationship with food meant she scored 3/3 in daughters with eating disorders 🙄 . Currently on an ivf diet which seems to be its own eating disorder/controlling something. But the point I meant to make is that at one point I told myself I can “binge” if I need to but started making it rivita with cucumber and houmous or a whole roasted head of broccoli with satay sauce or a giant bowl of popcorn made at home. Part of it is climbing out of an emotional black hole though too.

Say you’re getting one prescription, it costs £9.95 on prescription. However, the actual cost to the NHS starts from £133 depending on which specific jab you’re getting (and I don’t think this is actually the updated cost, so it’ll be more!). OP is lazy and a cheapskate. Either she runs privately or accepts she’s the problem and changes her lifestyle. Can’t hack your way out of this one.

This.

Well done on your weightloss op. You've proved you can do it so just stick to amounts you've been consuming this past year?

As others have said there is set criteria that GPs have to adhere to.

@Hakunatomato There is no reward for working and doing the right thing. Take the piss, and everything is handed to you on a plate.

iI was really sympathetic until this last statement. I know how hard it is to lose weight and keep it off but there’s no need to punch down in this manner. The rest of us could say that there’s no reward for us to keep our bmi well below 46. It’s not the fault of your gp, that he can’t prescribe this. I’ve worked hard all my life and yet there is fuck all mental health care when I need it but Im not blaming my gp or the unemployed and disenfranchised.

No, I'm not 'wrong.'

They will have to dig inside their mind, hard and deep, and muster up some willpower. As I said, it's untenable for people to take weight loss injections forever. The cost being the main reason (and £30 a week it is not, but even that is £120 a month!) Most people will not be able to afford it soon, and the NHS sure as hell won't be forking out for someone who has lost lots of weight on the jabs and then regained it. Through lack of willpower.

Many people went many years without them, time to face a life without them. Time for people to start taking responsibilty for their health and their body, and not say 'oooh but I can't do it without weight loss injections.' That is a defeatist attitude that has to stop. It's like when smokers claim they can't give up, and people who drink too much alcohol saying they need it. No, no you don't.

Time to start weaning yourselves off it. It will be better in the long run. No-one should be taking like this for life, that just makes them lose weight. It's not a neccessary thing to take your whole life, and no-one should be doing this IMO. You sould only be taking it to lose weight, and then for maybe 6 months after you get to target.

You don’t get to 10st overweight through lack of willpower though. GLP1s are not a willpower drug. They provide a biological fix that those with obesity need. It’s not a mental fix. There is something different biologically.

Interesting isn't it - everyone assumes it was just for weight loss - MJ and Ozempic (slightly diff drug) work on receptors which change cravings and "feelings" of hunger.

They were designed to help diabetics, weight loss was a side effect.

I think OP has done amazingly well and without it will find her blood sugars will start to get back out of control - for diabetics the drugs are for life.

DIabetes is progressive - its not just about being fat so you get diabetes. It is Insulin resistance in T2 diabetes which means body doesn't react well to your own insulin (and so you need more for standard types and amounts of food) There is damage to Beta cells in the pancreas and eventually as the DISEASE progresses the pancreas can fail.

Can we please remember that it is possible to be type 2, with good eating habits and exercise it is managed and SOMETIMES this pulls you back into normal ranges but not always and not forever.

I think in OPs position I would get a referral to a consultant to look at management of her diabetes and look for a change in her diabetes medication to include MJ or similar. Unfortunately this may mean short term coming off the MJ and her GP seeing what then happens to her BS - but manage this carefully as of course with higher BS you are at risk of diabetic retinopathy and neuropathy with higher BS. I was here in Jan - they took me off OZ to give me something else and ended up stage one retinopathy due to high BS as they completely messed with my drugs and didn't follow up with monitoring so got referred to hospital to sort me out and poss put me on insulin but am managing with out at the moment - but I am back on Oz and they have accepted that I am back in control (HBA1C of 60 at the moment, but target of 48, not sure I will get there but working on it and it takes time to come down as there is no magic bullet)

The better news is that the pharma that owns MJ is negotiating with pharmacists at the moment and it may be not such a big price increase in the short term etc, plus I would have a look at other drugs as well.

I think the problem at the moment is that everyman and his dog wants the drug as it is so helpful to drop weight and the diabetics are getting caught up in that. THink of the money saved by helping diabetics keep control and avoiding amputations, heart disease, liver, kidney and pancreas complications and god forbid a diabetic gets sepsis - bacteria thrives on sugary blood. ITs not all about "Will Power" everyone's diabetes is individual to them as is what foods they can and cant eat/what medications work/what exercise is possible etc - there is too much we don't know about this condition yet. Don't even get me on the connection with Dementia and particularly vascular Dementia as well.

I really don't think many people commenting on here have a clue about eating disorders. I am on the opposite end of the spectrum, I have ARFID and don't eat enough but sadly there isn't much help for an adult with ARFID so I just have to put up with it (like the OP I have tried endless things to help myself to no avail).

I think it's dreadful that people with obesity finally find something which helps with dramatic results and then it's taken away from them again because the greedy manufacturers decide they want to make even more out of their misery.

I'm sorry you are going through this OP, sadly the NHS and your GP do have their hands. I hope that you do, somehow manage to maintain the good work you have put in already.

Why will all your hard work be undone? After 5 stone you must have made some changes to your lifestyle and diet so can’t these continue? Remain in a calories deficit, eat healthy and the weight will continue to come off and your diabetes in remission.
if you haven’t adapted what you eat and have relied solely on the WLI then whenever you stop you will gain weight or pay for life.
It’s not the GP fault tbh