NHS weight loss injections 2026: who can get Mounjaro and Wegovy

What the NHS offers in 2026

Two GLP-1 medicines are available on the NHS for weight management: Mounjaro (tirzepatide) and the Wegovy injection (semaglutide). Each sits under its own NICE technology appraisal with its own criteria and its own setting. Mounjaro can be prescribed by a GP in England, in phases. Wegovy is restricted to specialist weight management services. The NHS website says you will usually only be prescribed tirzepatide for weight loss if your BMI meets the criteria, and that the criteria depend on whether you get it from your doctor or a specialist service.

The Wegovy pill and Foundayo are not available on the NHS. The figure that matters once you are prescribed either injection is the prescription charge: £9.90 per item in England, nothing in Scotland, Wales or Northern Ireland.

Mounjaro: NICE TA1026 and the phased rollout

NICE recommends tirzepatide for adults with an initial BMI of at least 35 and at least one weight-related comorbidity. NHS England is applying that recommendation in stages because of the number of people who qualify. Its interim commissioning guidance sets out the plan.

Specialist weight management services could prescribe from 24 March 2025, 90 days after NICE published final guidance. GP practices began on 23 June 2025, 180 days after publication, with cohort one only. The cohorts are:

The five qualifying conditions are atherosclerotic cardiovascular disease, hypertension, dyslipidaemia, obstructive sleep apnoea and type 2 diabetes. NHS England expects about 220,000 eligible people to be identified over the first three years and says the full rollout may take up to 12 years. Wrap-around support including nutritional and dietetic advice is a mandatory part of treatment in every setting.

The BMI threshold is reduced by 2.5 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds, so a BMI of 37.5 counts as 40.

Meeting the criteria does not guarantee a prescription. Local NHS bodies control the pace, and some practices are not yet prescribing. Ask your GP practice directly.

Wegovy: NICE TA875 and specialist services

NICE guidance TA875 recommends semaglutide for weight management only when all of the following apply: it is used within a specialist weight management service providing multidisciplinary management, the person has at least one weight-related comorbidity, and treatment lasts a maximum of two years. The guidance rationale describes people with a BMI of at least 35, or 30 to 34.9 if they meet the criteria for referral to a specialist service, with the same 2.5 reduction for the ethnic groups named above.

NICE adds that stopping should be considered if less than 5 per cent of initial weight is lost after six months. There is no GP prescribing of Wegovy for weight management under TA875. Your GP can refer you to a specialist service, and waiting times vary by area.

What an NHS prescription costs

In England the charge is £9.90 per item, and one four-week pen is one item. Twelve pens a year cost £118.80 at the item charge. A 12-month prescription prepayment certificate costs £114.50 and covers every NHS prescription item you have in the year, so it saves £4.30 on the pens alone and more if you have other prescriptions. The 3-month certificate costs £32.05. The prepayment certificate guide covers how to buy one and pay by direct debit.

Prescriptions are free in Scotland, confirmed by NHS inform. In Wales, anyone registered with a GP in Wales is entitled to free prescriptions from a pharmacist in Wales, per the Welsh Government. In Northern Ireland, nidirect states all prescriptions dispensed there are free for everyone. The charges by nation guide has the full picture. Many people in England also pay nothing because of age, income or a medical exemption, set out in the free prescriptions guide.

The saving against private prices

Private prices for the same pens on 21 October 2026 ran from £105.00 to £234.00 a month for Mounjaro on the cheapest ongoing price, and from £74.00 to £199.88 for Wegovy. An NHS patient in England pays £9.90. At Mounjaro 15 mg the cheapest private pen was £234.00 a month, or £2,808.00 over 12 pens, against £118.80 for 12 items at the NHS charge. In Scotland, Wales and Northern Ireland the whole private cost is saved. The private figures are on the Mounjaro price page and the Wegovy price page.

Steps to ask for NHS treatment

1. Check your BMI and list any diagnosed conditions from the five in the table. Only a diagnosis on your GP record counts.
2. Contact your GP practice and ask whether it is prescribing tirzepatide under NICE TA1026 and which cohort it is treating.
3. If you fall outside the current cohort but have a BMI of 35 or more with a comorbidity, ask about referral to a specialist weight management service, which can prescribe tirzepatide under TA1026 or semaglutide under TA875.
4. Attend the wrap-around support offered. NHS England makes it a condition of treatment.
5. In England, buy a prepayment certificate before the first prescription if you expect 12 items in the year.

Mistakes that cost money

Paying privately while waiting for an NHS answer without checking the current cohort first. Buying a 12-month private plan a month before an NHS prescription starts. Paying £9.90 per item in England when a prepayment certificate or an exemption would cover it. Assuming a private pharmacy's statement about NHS eligibility is correct rather than reading the NICE and NHS England pages linked here.

Where the figures come from

Eligibility is from the NICE TA1026 and TA875 recommendations and NHS England's interim commissioning guidance. The prescription charge and prepayment certificate prices are from the NHS website and NHSBSA. Free prescriptions in Scotland, Wales and Northern Ireland are from NHS inform, the Welsh Government and nidirect. The NHS position on the Wegovy pill and Foundayo is from the MHRA press releases of 11 June 2026 and 10 August 2026 on GOV.UK. Private prices are from GLP Index, checked 21 October 2026.