The makers of Mounjaro have been accused of having a ‘monopoly’ on the sector following concern over the rising costs of prescription medication.
Councillor Connor McManus, chair of Midlothian’s Integration Joint Board which oversees health and social care spending, described the impact of brands on the price of prescription medications as ‘sad’.
And he singled out Eli Lilly, who make Mounjaro and Foundayo medications – both GLP 1 products which are used to treat type two diabetes and in weight management.
He was speaking after the board’s financial adviser said the cost of GLP 1 medicines which gained a high profile as a weight loss drug used by celebrities to the NHS is going up by £3million a year in the Lothians.
Financial officer Ellie Ho told a meeting of the board that the estimated overspend on prescriptions for Midlothian had gone from £50,000 to £1.7million and was being driven by availability and cost of drugs, with GLP 1 medications – used for treating diabetes – having a significant impact.
However she said the sudden leap in costs had been caused in part by an error in the initial estimate but GLP1 drugs were pushing up the cost across the Lothians.
GLP 1 drugs can be used to treat diabetes and promote weight loss management and MS Ho stressed the cost in Midlothian was related solely to diabetes with no figures available for the impact of using it for weight loss.
She told the board meeting, last week: “The GLP spend is growing by around £3m across Lothian year on year but this is expected. These drugs work for the treatment of diabetes.
“We have to make sure the right governance is in place to make sure the spend is correct and make sure we keep the weight management pathway separate from the diabetes pathway so we don’t muddy the waters.”
GLP 1 medications such as Mounjaro have become well known as celebrities have been reporting losing weight using them.
Councillor McManus said: “The tricky thing with the GLP 1s is the brand monopoly on it – they cost a lot of money. Even for your average consumer that can purchase them now they are extremely expensive.
“It is tricky when you have brands such as Eli Lilly that do have that monopoly over that medication sector. It is just how the medication game can go sometimes and it is sad, to be honest that it is costing us more money.”
A spokesperson for Eli Lilly pointed out it was not the only manufacturer of medication in the sector and its products had been approved by the Scottish Medicines Consortium for use.
They said: “The Scottish Medicines Consortium (SMC) reviews medicines for clinical and cost effectiveness to decide which medicines are accepted for use by NHS Scotland.
“Lilly has had medicines for type 2 diabetes and for weight management accepted by SMC and is not the only company or medicine in these therapy areas. In 2025, Lilly reached a commercial agreement with NHS Scotland to maintain patient access.”
The integration joint board’s chief officer Morag Barrow stressed the benefits of the drugs in treating diabetes and preventing future cases had to be taken into account.
She said: “GLP 1 if it is safely assessed and monitored is a good thing. It is an early intervention and prevention for a lot of people particularly starting at the weight management part of things and avoiding going on to diabetes as well.
““We have to remember that while it is a challenge for us at this point in time ultimately we will start to see improvements in term of long term condition management.”
By Marie Sharp Local Democracy Reporter
