England to pay GPs up to £3,000 a year for prescribing Mounjaro

England will begin paying general practitioners bonuses for prescribing Eli Lilly's Mounjaro (tirzepatide) from April, as part of the country's 2026/27 GP contract ^[1]. The payments are designed to speed an NHS rollout that has moved slowly, with some patients who are eligible for the drug not being prescribed it ^[1].

The change runs through the Quality and Outcomes Framework, an existing NHS pay-for-performance program. GPs can receive up to £3,000 per year for Mounjaro prescriptions and another £1,000 for referring patients to weight-loss programs, according to a BBC report cited by pharmaphorum ^[1]. The initiative is backed by £25 million in guaranteed funding ^[1].

The Department of Health and Social Care said primary care is central to getting obesity drugs to more people and to reducing NHS costs. Between 2023 and 2024, almost two-thirds (64.5%) of adults aged 18 and over in England were estimated to be either overweight or living with obesity, and the government has estimated that obesity costs the NHS about £11.4 billion every year ^[1].

"Weight loss drugs can be a real game-changer for those who need them. I'm determined that access should be based on need, not ability to pay," said DHSC Secretary Wes Streeting ^[1]. He added that outside the NHS, people who can afford it have been buying the drugs privately, and that "the proliferation of rogue prescribers peddling dangerous unlicensed drugs" is putting patients at risk ^[1].

The NHS started a phased rollout of Mounjaro last year to limit the financial impact of providing access to the drug ^[1]. Under current rules, it is an option only for severely obese individuals with a BMI over 40 and weight-related complications, with a lower threshold of 37.5 for certain ethnicities ^[1]. From next year, the source says accessibility will be widened to include people with a BMI of 35 or more plus comorbidities, though no specific date is given ^[1].

Not everyone favors the bonus approach. The National Pharmacy Association welcomed the initiative but called on the government to commission pharmacies to provide weight management services on the NHS rather than relying on "overstretched" GPs ^[1]. "The NHS rollout of weight loss treatments remains very slow, and only a handful of patients are being treated. In some parts of the country, it has hardly begun at all," said Henry Gregg, the NPA's chief executive ^[1]. "This means that the vast majority of patients will be receiving weight loss treatment from their pharmacy" ^[1].

Why it matters for patients

The English arrangement shows how directly a national health system can shape who gets tirzepatide and how quickly. Eligibility there is set centrally by BMI and related conditions, and doctors are now paid extra to identify and treat those patients ^[1]. No comparable national prescribing bonus for tirzepatide or any other GLP-1 has been reported in the United States, where decisions about coverage of Mounjaro and Zepbound are made plan by plan rather than under a single national rule.

That means the practical question for a US patient — whether a given drug is covered, and under what criteria — is answered by an insurer or employer plan, not by a national threshold like England's BMI cutoff of 40, or 37.5 for certain ethnicities ^[1]. It also means the pace of access can differ sharply: England's own rollout drew criticism that it had "hardly begun" in some areas even after the drug was cleared for NHS use ^[1].

It is not yet known how many patients the bonus payments will reach, how the payments will be verified, or whether they will be tied to prescription volume or to health outcomes. The source does not disclose those details ^[1].

What happens next

Bonuses begin in April under the 2026/27 GP contract ^[1]. The NHS's phased rollout, which began last year, continues alongside them ^[1]. Eligibility is described as widening from next year to people with a BMI of 35 or more plus comorbidities; the source gives no exact start date for that change ^[1].