Eli Lilly's £279 million UK deal includes a trial tracking weight-loss drug users' employment
A Lilly-funded UK study will test whether tirzepatide changes sick days and employment, an outcome rarely measured in drug trials that could shape how payers weigh obesity coverage.
Eli Lilly will put £279 million ($364 million) into the United Kingdom, including a five-year study of tirzepatide — the molecule in Mounjaro and Zepbound — that will track participants' employment status and sick days from work as well as their weight, diabetes risk and obesity-related complications [1][2].
The commitment was announced Monday, Oct. 14, 2024, at the close of the UK government's International Investment Summit, under a "strategic collaboration" with the Department of Health and Social Care and the Department for Science, Innovation and Technology [1]. Lilly said it anticipates making an additional £279 million of new investment in the UK over the coming years [1].
The study, named SURMOUNT-REAL UK, will be carried out with Health Innovation Manchester, subject to relevant approvals, and will explore the real-world effectiveness of tirzepatide in weight loss, diabetes prevention and prevention of obesity-related complications in adults with obesity [2]. Tirzepatide is a dual GIP/GLP-1 receptor agonist, sold as Mounjaro in the UK [2].
Rachel Batterham, Lilly's senior vice president for International Medical Affairs, said the collaboration "will add to the evidence base on the real world impact of obesity treatments on the health of people with obesity" and "will explore a broad range of outcomes including health-related quality of life and impact on individuals' employment status" [1].
Employment outcomes are the politically charged part of the package. The UK is contending with a high rate of "economic inactivity," defined as people neither working nor looking for a job, and almost a third of claims are attributed to long-term sickness, including pre-existing conditions such as obesity [1]. Health and Social Care Minister Wes Streeting wrote in the Telegraph that "widening waistbands" placed a significant burden on the NHS and the economy and were costing the health service £11 billion a year, adding that illness caused by obesity leads people to take an extra four sick days a year on average, while many are forced out of work altogether [1]. He said the injections could be "monumental" in tackling obesity and getting people back to work, but that the "NHS can't be expected to always pick up the tab for unhealthy lifestyles" [1].
Not everyone welcomes tying treatment to work. Dr Dolly van Tulleken, a visiting researcher at the MRC epidemiology unit at the University of Cambridge, told BBC Radio 4's Today program there are "some serious ethical, financial and efficacy considerations with such an approach," including "looking at people, or measuring people based on their potential economic value, rather than primarily based on their needs and their health needs" [1].
Other parts of the deal include £204 million over three years for a UK biotech hub provisionally called Lilly Gateway Labs, which would be Lilly's first such site in Europe and would give start-ups lab space and access to the company's expertise; Lilly already runs Gateway Labs in four US locations and is considering a second UK site [2].
In the UK, the Medicines and Healthcare products Regulatory Agency authorized Mounjaro as a weight-loss treatment, and the National Institute for Health and Care Excellence has recommended a phased rollout to nearly a quarter of a million people in the first three years — a plan currently out for stakeholder comment — starting with patients who have at least three complications such as hypertension, dyslipidaemia, obstructive sleep apnoea or cardiovascular disease [2]. About 64% of adults in England are overweight or living with obesity, and obesity costs the NHS around £11 billion a year, according to the Health Survey for England 2022 [2].
Why it matters for patients
Whether weight-loss treatment changes sick days or employment is not established. The study has not reported results, and no start date, enrollment size or detailed design has been disclosed. Until data exist, the claim that these drugs affect work remains a hypothesis being tested, not a finding.
The framing matters beyond the UK. Governments, insurers and employers often weigh indirect benefits — such as fewer missed workdays — when deciding whether to cover obesity drugs, and results from a company-funded real-world trial could be cited in those arguments. Van Tulleken's objection is that measuring patients by economic value rather than health need raises ethical questions [1]; no response from Lilly to that criticism appears in the coverage.
The drugs themselves are not changing. Tirzepatide is approved in the US as Mounjaro for type 2 diabetes and Zepbound for obesity, and this UK study does not alter those labels or US coverage rules. The trial tests the drug as already authorized, in a real-world setting [2].
What happens next
The study is subject to relevant approvals and is planned to run five years [2]. NICE's phased rollout plan for Mounjaro in England remains out for stakeholder comment [2]. Lilly said it expects to make an additional £279 million of UK investment in coming years and is weighing a second UK Gateway Labs site [1][2]. No completion date for the employment analysis has been reported.
Sources
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