GPs Pocket £3,000 For Hitting Mounjaro Targets

England’s GP practices stand to gain an average £3,000 annual bonus from April. The payment rewards maximum prescriptions of Mounjaro, the new NHS weight loss injection. Ministers frame this as equalising access beyond private payers.

Eligibility remains confined to the severely obese. Patients need a BMI over 40 plus related conditions, expanding slightly next year to BMI 35. By 2028, the NHS targets 220,000 users—patchy rollout so far shows GPs prescribe below expectations.

Private markets fill the gap. Over 1 million Britons inject weight loss drugs, nine in ten buying privately. Rogue sellers peddle unlicensed versions, as Health Secretary Wes Streeting notes.

Incentives form standard GP contract tools. Past bonuses boosted statins for heart risk, dementia diagnosis, and vaccinations. This marks the first for obesity drugs, tied directly to prescription volume.

Experts dismiss the impact. Obesity Health Alliance director Katharine Jenner calls it welcome but limited—eligibility unchanged, drugs work best with support. British Medical Association warns of no shift in NHS criteria, widening the pay divide.

Royal College of GPs flags workload strain. Widening prescriptions risks unsustainable demands and patient expectations mismatch. Clinical judgement, not cash, supposedly drives decisions.

Obesity burdens the NHS with 7% of bed days and £6.5 billion yearly costs. Successive governments since 1997 pledged prevention through food reform and activity. Delivery stalled amid industry lobbying.

Mounjaro joins Wegovy, the latter restricted to specialist services. Bonuses target GPs for one drug only. This isolates incentives from holistic care.

Rhetoric Versus Rollout

Streeting promises a shift from treatment to prevention. Bonuses invest in general practice for broad access. Reality counters: drugs treat existing obesity, not its causes.

Food environments foster the epidemic—ultra-processed foods comprise 57% of calories. No parallel incentives tackle marketing or sugar taxes. Prevention rhetoric persists across Labour and Tory tenures.

Incentive dependence signals deeper malaise. GPs earn £1,000 more for weight programme referrals. Financial nudges replace structural reform.

Public health policy recycles symptoms management. Statins lowered heart deaths; vaccines curbed measles. Obesity demands upstream fixes incentives sidestep.

Workload compounds the issue. GPs manage 12% fewer appointments than pre-pandemic levels. Bonus-driven prescriptions add pressure without capacity boosts.

Private uptake exposes state shortfall. Wealthy patients access Wegovy and Mounjaro immediately; NHS queues grow. Bonuses accelerate limited supply, not equity.

This blueprint repeats NHS patterns. Prescription addictions from dopamine drugs afflicted 250 without warnings, per recent reports. Regulators delay; incentives paper over gaps.

Institutional Incentives

GP contracts allocate 70% of funding via capitation, rest performance-tied. Bonuses total £82 million yearly here. Practices scale payments by list size—larger ones gain more.

No sanctions attach to under-delivery. Patchy Mounjaro rollout drew no penalties. Rewards flow one-way.

Obesity rates climbed from 13% in 1993 to 28% now. Cross-party failure spans Blair’s targets to Sunak’s mandates. Incentives treat the bill, not the ledger.

Citizens bear costs. Taxpayers fund bonuses and drugs; private payers subsidise parallel systems. Preventable disease drains £100 billion annually in wider economy hits.

NHS bonuses for Mounjaro prescriptions expose a system chasing pharmaceutical fixes. Decades of ignored prevention hollow out public health. Britain pays GPs to prescribe what deeper failures created—no more.