Has NICE issued a technology appraisal for tirzepatide (Mounjaro) in England, and what did it recommend? Is it reimbursed in Italy (AIFA) and South Korea (HIRA)? Cite each source.

England: Yes. NICE has published two technology appraisals for tirzepatide (Mounjaro, Eli Lilly). Both recommend it with restrictions: TA924 covers type 2 diabetes and TA1026 covers overweight and obesity. Italy: Yes. Mounjaro is reimbursed by the national health service (SSN) as class A, with prescribing governed by AIFA Nota 100. South Korea: HIRA's reimbursement committee judged it suitable for reimbursement in type 2 diabetes. I found no official record confirming it was then listed with a reimbursed price.

Approach: I searched NICE technology appraisal guidance, AIFA's class A/H lists, the AIFA Notes and AIFA's provisions register, plus HIRA's drug-master files and the Ministry of Health and Welfare's (MOHW) reimbursement price notices. For Korea's committee decision I also searched the web, using official HIRA and MOHW pages only.

England: NICE

TA924, tirzepatide for treating type 2 diabetes (published)

• Recommended for: adults whose type 2 diabetes is insufficiently controlled, alongside diet and exercise, only if all of these apply ^[1]:
  • triple therapy with metformin and 2 other oral antidiabetic drugs is ineffective, not tolerated or contraindicated; and
  • BMI is 35 kg/m² or more with specific obesity-related psychological or medical problems; or
  • BMI is under 35 kg/m² and insulin would have significant occupational implications, or weight loss would benefit other significant obesity-related complications.
• Ethnicity adjustment: lower BMI thresholds (usually 2.5 kg/m² lower) apply for people from certain ethnic backgrounds.
• Price condition: the recommendation applies only if Lilly supplies it under its commercial arrangement.
• Why: NICE judged the cost-effectiveness estimates to be within its acceptable range, so tirzepatide is recommended for routine NHS use ^[2].
• List prices for a 4-week supply: £133 (2.5 mg), £180 (5 mg), £255 (7.5 mg and 10 mg), £330 (12.5 mg and 15 mg). The commercial arrangement is confidential ^[3].

TA1026, tirzepatide for managing overweight and obesity (published)

• Recommended for: adults with an initial BMI of at least 35 kg/m² and at least 1 weight-related comorbidity, alongside a reduced-calorie diet and more physical activity. It also depends on the commercial arrangement, and lower BMI thresholds apply for certain ethnic groups ^[4].
• Stopping rule: if less than 5% of initial weight is lost after 6 months on the highest tolerated dose, the clinician should reconsider whether to continue.
• Not recommended for the full population Lilly proposed (BMI of 30 kg/m² or more with 1 comorbidity), because the cost-effectiveness estimates for that group were above NICE's acceptable range ^[5].
• Phased rollout: a funding variation means access is introduced in phases under NHS England's interim commissioning guidance over 3 years ^[6]:
  • first eligible: BMI of 40 kg/m² or more plus 4 or more qualifying conditions;
  • from around June 2026: BMI of 35 to 39.9 kg/m² plus 4 or more conditions;
  • from around March 2027: further expansion to people with 3 conditions.

Italy: AIFA

• Class A listing: all 6 Mounjaro KwikPen packs (Eli Lilly Nederland BV) are on AIFA's class A list (31 May 2026 edition):

Strength (4 doses)	AIC	Public price
2.5 mg	050357490	€346.58 [7]
5 mg	050357514	€346.58 [8]
7.5 mg	050357538	€485.22 [9]
10 mg	050357553	€485.22 [10]
12.5 mg	050357577	€623.86 [11]
15 mg	050357591	€623.86 [12]

• Prescribing condition: reimbursement runs through Nota 100, AIFA's prescribing note for type 2 diabetes drugs. Tirzepatide is listed there as a GIP/GLP-1 dual agonist covered by the SSN ^[13].
• Key dates on the Nota 100 page:
  • 24/02/2025: AIFA notice that tirzepatide became reimbursable for type 2 diabetes;
  • 22/04/2025: electronic prescribing via the TS system was activated;
  • the Note itself was last updated 18/07/2025.
• I found no Italian reimbursement record for an obesity indication.

South Korea: HIRA

• Committee decision: according to a search snippet of an official HIRA page, HIRA's Pharmaceutical Reimbursement Evaluation Committee, at its 12th meeting of 2025, found Mounjaro Prefilled Pen (2.5 to 15 mg, Korea Lilly) suitable for reimbursement. The scope was an adjunct to diet and exercise to improve blood-sugar control in adults with type 2 diabetes.
• What I could not confirm: that decision is a step before price negotiation with the National Health Insurance Service (NHIS). I found no official source confirming that the negotiation succeeded or that Mounjaro was listed. MOHW's reimbursement price notices had no records for it under any of its product codes.
• Drug-master files are not proof of coverage: HIRA's master files hold Mounjaro product mappings (prefilled pens approved 2023-06-28, KwikPens 2025-09-05, vials 2025-12-12; ATC A10BX16) ^[14][15][16]. Tirzepatide also has ingredient codes in the 31 October 2025 snapshot ^[17]. These files carry codes, not insurance status.
• Obesity: I found no official source showing reimbursement for obesity.

Sources:

• HIRA, Pharmaceutical Reimbursement Evaluation Committee results list