Australia’s Weight-Loss Drugs: Will They Be Subsidized?
Subsidized Weight-Loss Drugs in England
People with a high body weight living in England can now access subsidised weight-loss drugs to treat their obesity. This includes Wegovy (the weight-loss dose of Ozempic, or semaglutide) and Mounjaro (one of the brand names for tirzepatide).
Australia’s Decision
However, in Australia, the government subsidises the cost of semaglutide (Ozempic) for people with diabetes. But it is yet to subsidise semaglutide (Wegovy) on the Pharmaceutical Benefits Scheme (PBS) for weight loss.
This leaves Australians who use Wegovy for weight loss paying around A$450–A$500 out of pocket per month.
Australia’s PBAC and NICE
The Pharmaceutical Benefits Advisory Committee (PBAC) reviews the submissions pharmaceutical companies make for their drug therapies to be subsidised through the PBS.
NICE (the National Institute for Health and Care Excellence) has a similar role in England, informing decisions to subsidise medicines.
PBAC’s Decision
PBAC concluded semaglutide should not be subsidised through the PBS because it didn’t consider the drug cost-effective at the price proposed.
NICE’s Decision
NICE, on the other hand, subsidises semaglutide in England for adults with at least one weight-related condition and a BMI of 30 or above.
Why Did They Reach Such Different Decisions?
NICE assessed the use of GLP-1 agonists for a broader population than PBAC: people with one weight-related condition and a BMI of 30 or above.
Another difference was that NICE’s cost-effectiveness analysis included estimates of the longer-term benefits of these drugs in reducing the risk of diabetes, cardiovascular (heart) disease, stroke, knee replacement, and bariatric surgery.
Consequences
PBAC’s decision limits the potential impact of GLP-1 agonists on the health budget.
Maybe this approach will work and the Australian government will pay less for these drugs the next time it considers publicly funding them.
Conclusion
GLP-1 agonists are not on the agenda for the forthcoming PBAC meetings, so there is no timeline for when GLP-1 agonists might be funded in Australia for weight loss.
FAQs
- What are GLP-1 agonists?
GLP-1 agonists are a class of medications that help the body produce insulin and regulate blood sugar levels.
- Why are GLP-1 agonists used for weight loss?
GLP-1 agonists can help with weight loss by reducing hunger and increasing feelings of fullness and satisfaction.
- How much do GLP-1 agonists cost in Australia?
Australians who use Wegovy for weight loss or heart disease pay A$450–A$500 out of pocket per month.
- Can I get GLP-1 agonists subsidized in Australia?
No, PBAC has not subsidized semaglutide (Wegovy) on the PBS for weight loss.
