Side effects, sky-high prices: Is the weight loss drug Mounjaro worth the wait?

Bengaluru: With the announcement of the launch of the antidiabetic drug Mounjaro in the Indian market, diabetologists in Bengaluru have reported a sharp spike in patient interest.

Mounjaro, the brand name for the weekly injectable medication Tirzepatide, sold by American pharmaceutical company Lilly, is a dual Glucose-dependent Insulinotropic Polypeptide (GIP) and Glucagon-like Peptide-1 (GLP-1) receptor agonist, regulating blood sugar and suppressing appetite.

Several studies have shown sustained weight loss and a lower risk of progression to Type 2 diabetes with regular doses of Tirzepatide, which comes in doses ranging from 2.5 mg to 15 mg. The longer a patient continues the treatment, the better the results over time, note diabetologists.

Dr Basavaraj GS from Narayana Health City, Bengaluru, explained that the real-world potential of another antidiabetic drug, Semaglutide (popular as Ozempic), was about 5-8%. He expects Mounjaro to cause up to 10% weight loss in diabetics.

"Until Mounjaro has been tested and approved in Indian settings for obesity without diabetes, it might be experimental for that group," he said.

Currently, Mounjaro (Tirzepatide) is approved to treat obesity linked with diabetes.

Bariatric surgery

Dr Pramila Kalra from Ramaiah Memorial Hospital was also of the opinion that this drug could potentially replace bariatric surgery for weight loss. She noted that some studies have shown up to 26% weight loss among diabetics.

"Mounjaro is also approved for obesity alone in people with a BMI over 30 without Type 2 diabetes. In people with a BMI below 30, it is approved for obesity with other comorbidities such as diabetes or a strong predisposition to develop diabetes. It can be used as a weight-loss drug in people with a BMI over 30, even if the patient does not have diabetes," Dr Pramila said.

The treatment is expected to cost Rs 14,000 per month for the lowest dose of 2.5 mg (Rs 1.68 lakh per annum), which is expensive for many patients. However, doctors across hospitals are observing high demand for the treatment, with many patients on the waiting list.

Apart from having shown "extraordinary" results for diabetes, Dr A Sharda from Manipal Hospitals, Millers Road, explained that the drug also reduces the risk of heart, liver, and kidney complications from diabetes, as well as preventing heart attacks in diabetic patients with a history of heart issues.

"This cannot be given to patients with pancreatitis. Doctors also have to be cautious when prescribing this for patients with diabetic retinopathy. Additionally, gastrointestinal side effects can be managed within two months. People need to know that if they stop this medication, there is a possibility of regaining the lost weight," she said.

Dr Srinath Aswathiah from Gleneagles BGS Hospital, Kengeri, noted that the most common side effects of Tirzepatide are nausea and vomiting, along with other gastrointestinal (GI) tract issues and the risk of a rare type of thyroid cancer. However, it has a better side-effect profile compared to Semaglutide.