People with severe obesity and established cardiovascular disease will get Wegovy on the PBS, after some price negotiations.
Health Minister Mark Butler has kicked off the new year assuring Australians that he’s acting on the Pharmaceutical Benefits Advisory Committee recommendation that Wegovy be subsidised for obesity treatment for a select group.
The PBAC also said the drug would be useful for prevention, but that we can’t afford that under current prices and widespread use could lead to high levels of adverse events that would outweigh the benefits.
“I, just before Christmas, received some recommendations from the experts that oversee the PBS … that we should look at a listing on the PBS of Wegovy, in particular for people with a certain level of obesity, so a BMI of 35, but also some established cardiovascular disease,” Minister Mark Butler told Channel Seven’s Sunrise program on Friday.
“Now, I only got that just before Christmas. We’ll be working with the company to sit down and agree a price that works for them but also works for taxpayers, because we’re committed to listing every recommendation we receive from that group of experts.
“There’ll be more work to do though with this class of drugs. It really is an extraordinary innovation we’re seeing sweeping the world.
“Right now, there’s more than 400,000 Australians who pay private prices just to get this weight loss benefit and other benefits as well. But that’s as much as $4,000 or $5,000 a year. It’s beyond the means of many Australians who really would benefit from this. It’s an equity issue as well as a health issue, from my perspective.”
GLP-1 drugs are currently available on the PBS only for people with type 2 diabetes.
In 2025, the PBAC conducted a review of equitable access to GLP-1 obesity treatment at Mr Butler’s request.
Its advice, provided along with recommendations at the PBAC November meeting, was that priority groups included people with established cardiovascular disease, Aboriginal and Torres Strait Islander patients with obesity-related comorbidities, people with syndromic obesity, people with medication-induced obesity and those requiring weight loss to be eligible for surgery.
Support for diet and exercise was needed and digital models could provide more equitable access to that, but “there should not be any mandatory requirements for use of wraparound services for PBS-subsidised access to GLP 1s, as this would create a barrier to accessing therapy”, the advice said.
At the same meeting, it recommended that:
semaglutide be subsidised through the Pharmaceutical Benefits Scheme (PBS) for adults with established cardiovascular disease (eCVD) with obesity. Patients must have already experienced a cardiovascular event such as a heart attack, stroke, or have symptomatic peripheral arterial disease. The PBAC noted the submission proposed three potential patient populations based on different Body Mass Index (BMI) cut-offs: ≥27 kg/m2, ≥35 kg/m2 and ≥40 kg/m2. To best reach patients at high risk and considering the high cost of treatment, the PBAC determined it would be appropriate to limit PBS access to people with a BMI of 35 kg/m² or higher, or 32.5 kg/m² or higher for people of Asian, Aboriginal, or Torres Strait Islander ethnicity.
However, the PBAC wanted the manufacturer, Novo Nordisk Pharmaceuticals Pty Ltd, to reduce the price of the drug, saying that “some of the assumptions the sponsor used to justify its requested price were inaccurate and that the sponsor had overstated the benefits of semaglutide, particularly in the duration of benefit for people who discontinue treatment”.
It advised that:
A reduction in the price was required to reflect more realistic estimates of benefits. The PBAC considered there was a significant risk that people would access subsidy for semaglutide outside of the proposed criteria (particularly for patients with established cardiovascular disease and a BMI of less than 35 kg/m2) and patients with high cardiovascular risk but no prior cardiovascular event). It therefore advised that a risk sharing arrangement with the sponsor was required to adequately manage the expenditure risk to the Commonwealth.
In its advice to the minister, the PBAC said the rollout of PBS access should be “slow and managed” to “help to manage leakage and uncertainties around long-term use and outcomes”.
Related
The RACGP updated its position on obesity prevention and management in March 2025, recommending “increased government support for clinical services, effective obesity-management adjunct therapies including equitable access to public-funded bariatric metabolic surgery and PBS subsidised obesity-management medication”.
In December last year, the WHO issued a new guideline with “conditional recommendations for using these therapies to support people living with obesity in overcoming this serious health challenge, as part of a comprehensive approach that includes healthy diets, regular physical activity and support from health professionals”.
The two main recommendations are:
- GLP-1 therapies may be used by adults, but excluding pregnant women, for the long-term treatment of obesity. While the efficacy of these therapies in treating obesity and improving metabolic and other outcomes was evident, the recommendation is conditional due to limited data on their long-term efficacy and safety, maintenance and discontinuation, their current costs, inadequate health-system preparedness, and potential equity implications.
- Intensive behavioural interventions, including structured interventions involving healthy diet and physical activity, may be offered to adults living with obesity prescribed GLP-1 therapies. This is based on low-certainty evidence suggesting it may enhance treatment outcomes.
The peak body for dietitians, Dietitians Australia, welcomed the recommendation at the time, but warned that safeguards were needed.
“GLP1RAs suppress appetite, and without appropriate nutrition support, people will be at risk of malnutrition, loss of muscle and bone mass, and the development of disordered eating,” said CEO Magriet Raxworthy.
“Without a dietetic guarantee in the use of the medicines, and expanded patient access to dietitians in primary care, the public health investment is wasted.
“Lasting improvements in health are achieved through comprehensive, multidisciplinary care that includes funded access to evidence-based nutrition support before, during and after treatment.”
