Reason for request
Inclusion on list
Summary of opinion
Favourable opinion for reimbursement only as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with an initial body mass index (BMI) ≥ 35 kg/m² in the event of failure of well-conducted nutritional management (< 5% weight loss after six months).
Unfavourable opinion for reimbursement in the other situations covered by the MA indication.
Clinical Benefit
| Substantial |
The clinical benefit of MOUNJARO (tirzepatide) is substantial only as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with an initial body mass index (BMI) ≥ 35 kg/m² in the event of failure of well-conducted nutritional management (< 5% weight loss after six months).
|
| Insufficient |
The clinical benefit of MOUNJARO (tirzepatide) is insufficient to justify public funding in the other MA situations.
|
Clinical Added Value
| minor |
Considering:
- new efficacy data from three placebo-controlled studies conducted in patients with a mean BMI of over 35 kg/m², confirming the substantial efficacy of tirzepatide on weight loss,
- the results of an open-label study that evaluated weight loss with tirzepatide compared to semaglutide, which are difficult to interpret due to methodological limitations,
- results for clinically relevant morbidity endpoints in obese patients, from three studies (SUMMIT, SURMOUNT-OSA, SURMOUNT-1 extension),
- the results of the SUMMIT study concerning patients with heart failure, demonstrating a benefit on a composite endpoint including cardiovascular deaths and worsening of heart failure, which nonetheless did not demonstrate a reduction in cardiovascular deaths,
- the results of the SURMOUNT-OSA study, which demonstrate a benefit for change in apnoea-hypopnoea index,
- the results of the SURMOUNT-1 extension study, which demonstrate a benefit for time to onset of type 2 diabetes in the long term (193 weeks) in patients with prediabetes,
- an improvement of quality of life demonstrated in the SUMMIT study for change in Kansas City Cardiomyopathy Questionnaire Summary Score (KCCQ-CSS),
- the safety profile marked predominantly by gastrointestinal adverse events with, in particular, extensive experience in the SURMOUNT-1 study, with follow-up for up to 193 weeks,
pending the results for the cardiovascular endpoints in the SURMOUNT-MMO study, the Committee deems that MOUNJARO (tirzepatide) provides a minor clinical added value (CAV IV), in the same way as WEGOVY (semaglutide), in the care pathway for adult patients with an initial body mass index (BMI) > 35 kg/m² in the event of failure of well-conducted nutritional management (< 5% weight loss after 6 months) and as an adjunct to a reduced-calorie diet and physical activity.
|
| Not applicable |
|
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
dQkqpR6M7yd2gyT7