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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