In a major development for public health, millions of Australians living with obesity are a step closer to affordable access to the blockbuster weight-loss medication Wegovy. The federal government is preparing to act on expert advice to subsidise the Ozempic-like drug through the Pharmaceutical Benefits Scheme (PBS).
Eligibility and Expert Recommendation
The pivotal move follows a recommendation from the Pharmaceutical Benefits Advisory Committee (PBAC) that Wegovy be listed on the PBS for adults with obesity who also have established cardiovascular disease. Health Minister Mark Butler confirmed the government will now enter price negotiations with the drug's manufacturer, Novo Nordisk.
Access will be tightly controlled to ensure it goes to those with the greatest clinical need. To qualify for the subsidy, patients must have experienced a serious cardiovascular event, such as a heart attack, stroke, or symptomatic peripheral arterial disease. They must also meet strict weight thresholds, though the exact criteria are not yet public.
A Matter of Equity and Health
Minister Butler highlighted the significant financial barrier currently facing hundreds of thousands of Australians. "Right now, more than 400,000 Australians are paying private prices just to get this weight-loss benefit - as much as $4,000 or $5,000 a year," he said. "It's beyond the means of many Australians who would genuinely benefit. It's an equity issue as much as a health issue."
Wegovy, a GLP-1 medication similar to Ozempic, works by suppressing appetite and can lead to significant weight reduction. The need for such treatments is clear: data from 2022 showed that 13 per cent of Australian adults fall into the 'severe obesity' category, defined by a Body Mass Index (BMI) of 35 or more.
Cost Reduction and Broader Implications
While there is no confirmed timeline for the PBS listing, its impact on cost will be substantial once it proceeds. Thanks to changes introduced on January 1, the maximum price for PBS-listed medicines is now $25 per prescription, and just $7.70 for concession card holders.
Clinical experts have welcomed the targeted approach. Dr Mark Mellor, lead clinician at the Perth Weight Clinic, stated the drug is beneficial not only for weight loss but for preventing future heart problems. "To help prevent patients from having another cardiovascular event or dying from cardiovascular disease... It makes sense that we need to treat these people if they want that treatment," he told the ABC.
However, some medical professionals caution against viewing medication as a sole solution. Dr Michael Tam of the Royal Australian College of General Practitioners warned that while PBS listing would improve equity, it must not come at the expense of preventive health. "We know these treatments are effective for individuals, but ideally, we want to reduce the burden of obesity from occurring in the first place," Dr Tam said.
The global demand for GLP-1 medications has surged, prompting the World Health Organisation in December to urge governments to improve affordability. In a related development, Wegovy could also be approved in a pill form in Australia following its recent launch in the United States.
