ManufacturerEli Lillyhas announced significant changes for users of itsMounjaropre-filled injection pens, including a modification to the pens themselves and a substantial price increase. These changes have sparked considerable outrage among patients and raised concerns about medication access and safety.

Currently, Mounjaro pens are 3ml in size, designed to deliver a fixed amount of the drug once a week for four weeks. However, a small amount of medication often remains after the final injection. This surplus, colloquially known as the 'golden dose,' has been salvaged by some users with a syringe and needle to obtain an additional, fifth dose, potentially saving them around £615 annually. Eli Lilly's upcoming modification to the KwikPen aims to reduce this leftover medicine, thereby preventing users from accessing any spare medication for an additional jab.

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This pen modification comes in the wake of an earlier announcement by Eli Lilly that wholesale prices of Mounjaro would more than double from September 1. The highest dose is set to increase by 170 percent, from £122 to £330 a month, while mid-range doses, such as the 5mg pen, will jump from approximately £92 to £180. This price surge previously triggered what users described as 'Covid-like panic buying,' with many attempting to stockpile months' worth of injection pens to avoid the new costs. Slimmers also took to social media to share tips on how to perform the 'golden dose' hack, aiming to extend the longevity of their pens under the new pricing structure.

An Eli Lilly spokesperson confirmed that a modifiedKwikPenwould be made available globally, with timelines for UK availability yet to be determined. They stated that both the initial and modified Mounjaro KwikPens contain the volume of solution necessary for priming before each injection and the delivery of four weekly doses, with the modification specifically designed to reduce the residual medicine after four doses have been administered.

Mounjaro patients have reacted with fury to Eli Lilly's decision, calling it a 'kick in the teeth' and expressing their intent to continue trying the 'golden dose' hack, even suggesting combining leftovers from multiple new pens for a 'golden 9th' dose. Social media forums reflected widespread discontent, with users questioning the company's profitability and ethical practices.

Despite patient determination, health chiefs have repeatedly urged against attempting the 'golden dose' hack due to significant health risks. Dr. Alison Cave, chief safety officer of the MHRA, emphasized that patients must adhere to dosing directions provided by healthcare providers and outlined in the patient information leaflet. She warned that tampering with pre-dosed injection pens could lead to personal injury or harm to health, as medicines are approved based on strict dosage guidelines.

Professor Penny Ward, a pharmaceutical expert atKing's College London, further elaborated on the dangers. She highlighted the risks of serious side effects from overdosing and the potential for developing life-threatening infections. Professor Ward explained that while the pens are sterile when dispensed, they become non-sterile after initial use. Extracting and injecting leftover liquid from a non-sterile pen could introduce harmful bacteria, potentially leading to an abscess—a painful buildup of pus—or even progressing to sepsis, a life-threatening condition where the body's organs begin to shut down.

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The broader context of Mounjaro's availability in the UK also contributes to patient frustration. Under official guidelines, Mounjaro is prescribed on the NHS only to patients with a Body Mass Index (BMI)over 40 and co-existing weight-related health problems such as high blood pressure, type 2 diabetes, or obstructive sleep apnea. However, tens of thousands are believed to be using the drug privately.

A recent analysis by the British Medical Journal revealed a 'postcode lottery' in NHS provision, with less than half of England's commissioning bodies having started prescribing the drug since its phased 12-year rollout began in June, despite millions of obese patients being slated to receive it. This situation underscores the significant demand for effective weight-loss medications, particularly as weight-related illness costs the UK economy £74 billion annually, with two in three Britons classified as overweight or obese.