On Today with Claire Byrne, Maura Fay reports on the rollout of Mounjaro in Ireland and speaks to medical experts about issues surrounding access to this medication. Listen back above.

The most effective weight-loss drug on the international market will soon be available in Ireland. Mounjaro (tirzepatide) functions in a similar way to Ozempic, but studies have found that it leads to even greater weight loss – over 20% in the case of Mounjaro; as against 14% for Ozempic.

From the 17th of February this year, Mounjaro will be licenced for use as a treatment in Ireland for both type 2 diabetes and obesity. Maura Fay spoke to Dr Michael Crotty, clinical lead for obesity in the Irish College of General Practitioners. He says that having the disease of obesity is different to being "overweight":

"This is a treatment for obesity. Obesity is a medical condition where excess fatty tissue has a negative impact on health."

Dr Crotty says that Mounjaro is a lifelong medication for people with chronic illnesses and it's not meant to be used as a dieting tool:

"These medications have been misrepresented as 'skinny-jabs' quick-fixes, ‘Hollywood’s worst-kept secret’. That is not what they are for. It’s important we draw the distinction between the chronic disease of obesity, which is a medical issue - it's complicated - versus the cultural desire to be thin."

Drugs like Mounjaro and Ozempic aid weight loss, but weight loss alone doesn’t guarantee a healthy outcome. Dr Crotty explains there are consequences to rapid weight loss - like a sudden decrease in muscle mass, for example and people need support and guidance on how to stay healthy as they drop the pounds:

"I need lots of protein to protect my muscle mass so I’m not losing huge amounts of muscle. I need to prioritise fibre to make my gut work properly. I need to be focussing on sleep and stress, patterns of eating to improve my health. No one treatment is a cure."

Dr Crotty says the obsession with watching the number drop on the scales can lead to people putting up with uncomfortable side effects of losing weight, which he says are in no way beneficial:

"It’s frankly scary what people will put up with when they are losing weight."

Access to Mounjaro will be decided by a number of factors. The drug will be licensed for type 2 diabetes and obesity; and in the case of obesity, doctors can only consider patients whose weight exceeds a certain BMI. In some cases, other conditions may need to be present for patients to qualify for a prescription for Mounjaro. G.P.s will advise their patients on the specifics when the drug is licenced.

The drug will cost in excess of €215 per month, as this is the entry-level cost at which it will be supplied to distributors in Ireland. The big question many people want answered is will it come under the Drug Payments Scheme?. The short answer is no, but it is being considered.

There is a protocol in place to decide if a drug is "value for money" and it takes at least 6 months to complete, according to Professor Michael Barry, Clinical Director of the National Centre for Pharmoeconomics (NCPE). Professor Barry says that it’s possible a drug could be deemed value for money, but still be excluded from medical schemes like the drug payment cap of €80 per month. This is because the impact on health budgets could be so great that the system cannot sustain it. Taking both type 2 diabetes and obesity into account, Prof. Barry says the bill could be massive:

"When you combine both the indications for weight management and for diabetes, you could be looking at an expenditure of half a billion Euro over 5 years – I mean, that is substantial."

Prof. Barry says he thinks that some people who could benefit from Mounjaro won't be able to access it under a drug payment scheme, because of the cost:

"I don’t envisage a situation, where all patients who would potentially benefit from these drugs will actually be receiving them through the community drugs schemes. I just think that that would be unaffordable."

If access is restricted, the temptation can arise to buy "knock-off" cheaper versions of these drugs online. Maura read a statement from the Health Products Regulatory Authority, warning of the potential dangers of this course of action:

"Do not buy counterfeit versions of these medicines online or from other unregulated sources, as they may be falsified, counterfeit, contaminated, improperly stored and transported and this poses a significant risk to the health of those who used them."