Two weight loss injections are available on the NHS in England in 2026, but who can actually get them depends on strict rules about body mass index, other health conditions and where the prescription comes from. A GP in England can now prescribe Mounjaro to some adults, while Wegovy is only available through specialist weight management services. Neither the Wegovy pill nor the newer drug Foundayo is available on the NHS at all.

The picture was set out in guidance from NICE and NHS England, and in a check of the current rules published on 11 November 2026. Demand for the medicines is high, and the NHS is rolling them out in phases because the number of people who could qualify runs into the millions.

Mounjaro on the NHS: who qualifies first

Mounjaro, known by its generic name tirzepatide, is recommended by NICE in technology appraisal TA1026 for adults with a body mass index of at least 35 and at least one weight-related health condition, alongside a reduced-calorie diet and increased physical activity. The BMI threshold is reduced by 2.5 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds.

Because around 3.4 million people in England meet the full NICE criteria, NHS England is phasing access in through priority cohorts. GP practices began prescribing on 23 June 2025, but only to the first cohort: adults with a BMI of 40 or more and at least four of five named conditions. Those conditions are atherosclerotic cardiovascular disease, hypertension, dyslipidaemia, obstructive sleep apnoea and type 2 diabetes.

A second cohort, with a BMI between 35 and 39.9 and four of the five conditions, is planned for 2026/27, and a third cohort, with a BMI of 40 or more and three conditions, is planned for 2027/28. NHS England expects about 220,000 people to be identified over the first three years, and says the full rollout may take up to 12 years. Specialist weight management services have been able to prescribe tirzepatide to the full eligible group since 24 March 2025.

Meeting the criteria does not guarantee a prescription. Local NHS bodies control the pace of the rollout, some GP practices are not yet prescribing, and wrap-around support including nutritional and dietetic advice is a mandatory part of treatment. NICE also says that if less than 5 per cent of initial weight has been lost after six months on the highest tolerated dose, the clinician should decide whether to continue treatment.

Wegovy: specialist services only

Wegovy, the brand name for semaglutide, sits under a separate NICE appraisal, TA875, and works differently. It is only recommended within a specialist weight management service providing multidisciplinary care, for people with at least one weight-related condition, and treatment lasts for a maximum of two years.

There is no GP prescribing of Wegovy for weight management under the guidance. A GP can refer a patient to a specialist service, but waiting times vary by area, and the service itself decides whether the medicine is suitable.

What it costs on the NHS

For patients who are prescribed either injection in England, the charge is the standard NHS prescription charge of 9.90 pounds per item, and one four-week pen counts as one item. Twelve pens over a year therefore cost 118.80 pounds at the item charge, while a 12-month prescription prepayment certificate costs 114.50 pounds and covers every NHS prescription in the year. A three-month certificate costs 32.05 pounds.

Prescriptions are free in Scotland, Wales and Northern Ireland, so the medicine itself costs nothing there for patients who are prescribed it. Many people in England also pay nothing because of age, income or a medical exemption.

The contrast with private prices is stark. On 11 November 2026, private prices for the same pens ranged from 130 to 237 pounds a month for Mounjaro and from 79 to 196 pounds a month for Wegovy, according to the GLP Index price tracker. The cheapest private Mounjaro 2.5 mg pen on that day was 89 pounds.

What is not available on the NHS

Two newer options are private only. The Wegovy pill, an oral form of semaglutide licensed in the UK on 11 June 2026, is not available on the NHS, and neither is Foundayo, known generically as orforglipron, which was authorised on 10 August 2026. NICE has not published guidance recommending either for NHS use.

Anyone considering treatment should speak to their GP practice and ask whether it is prescribing tirzepatide under NICE TA1026, which cohort it is treating, and whether a referral to a specialist weight management service is appropriate. This article is general information about the published NHS rules, not medical advice, and individual decisions about treatment are for a patient and their clinician. Sources: The Dose Club and NHS England.