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The PBAC recommended it be listed for adults with established cardiovascular disease with obesity, while also identifying which groups could have more affordable access to GLP-1s.
The PBAC has released its recommendation on which groups should be prioritised to ensure ‘equitable subsidised access to GLP-1 for the treatment of obesity’.
Semaglutide (sold as Wegovy) is now a significant step closer to being added to the Pharmaceutical Benefits Scheme (PBS) for adults with established cardiovascular disease with obesity.
It comes after the Pharmaceutical Benefits Advisory Committee (PBAC) recommended the listing at its November meeting, releasing its decision late on Friday.
‘Patients must have already experienced a cardiovascular event such as a heart attack, stroke, or have symptomatic peripheral arterial disease,’ PBAC said.
‘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.’
The cost barrier to some Australians accessing weight-loss drugs more broadly could also soon be lifted following new PBAC advice to the health minister.
At the request of Federal Health and Ageing Minister Mark Butler, the PBAC undertook a comprehensive review of glucagon-like peptide-1 (GLP-1) receptor agonist medicines for obesity, focussing on equitable access.
The PBAC has now released its recommendation on which groups should be prioritised to ensure ‘equitable subsidised access to GLP-1 for the treatment of obesity’.
‘Based on current evidence’, the PBAC considered this should include:
- people with established cardiovascular disease
- Aboriginal and Torres Strait Islander patients with obesity-related comorbidities
- people with syndromic obesity
- people with medication-induced obesity
- patients requiring weight loss to be eligible for surgery.
However, it noted ‘any PBS listing would be subject to the legislative requirements to demonstrate clinical and cost-effectiveness through a sponsor-initiated submission’.
The PBAC said ‘cost was a concern and barrier to ongoing access for many consumers’.
It also flagged ‘private market data indicated that there was a high willingness to pay for obesity treatments among Australian consumers with around 420,000 people receiving a private market supply of semaglutide or tirzepatide in July 2025’.
The PBAC recommended to Minister Butler that the inclusion of GLP-1 medications on the PBS should be done at a controlled pace.
‘The PBAC advised a slow and managed rollout of access to PBS-subsidised GLP-1 treatments in the Australian healthcare system would help to manage leakage and uncertainties around long-term use and outcomes,’ it said.
‘The PBAC considered that there may be merit in broader subsidy of GLP-1s for early intervention and prevention of obesity-related comorbidities, but such subsidy would need to be established as a program outside of the PBS as it would be difficult to achieve a cost-effective price of providing obesity medicines for these broader purposes at this time.’
The committee also pointed out the potential for risks as more patients gain access to the drugs, saying that ‘if a large population were to be treated with GLP-1s, there would be an increased likelihood of rare, serious adverse events, which may outweigh the benefits in patients without pre-existing comorbidities and would inform ongoing appropriate use’.
Dr Michael Tam, a member of the RACGP Expert Committee – Quality Care said making GLP-1 medications more affordable for those who need it is a positive move.
‘As a clinician, my principal interest is to my patients, to the families and to my community, and it’s always better to have access,’ he told newsGP.
‘I welcome this because it means, at least in the domain that I work in, which is individual patient care, it will increase the access for my patients to effective treatments.
‘For a person living with obesity, and there are a lot of people out here at the moment that might think that they would benefit from these medicines, the reality might be that their social situation means that this is not realistic.
‘If these medicines come onto the PBS, then obviously that really changes access to these medicines and potentially the benefit will be greatest from an equity perspective.’
But Dr Tam cautions that health policy and funding also need to target obesity prevention strategies.
‘If we’re funding these medicines, that means that we’re going to have less funding or less future growth and funding overall for preventive health – things like addressing issues around built environment,’ he said.
‘It’s not a simple thing. We know these treatments are effective for individuals, but ideally, we want to reduce the burden of obesity from occurring in the first place.
‘It would be even better if we’re able to also support a healthy community so that less young people, less children, become obese adults, and those sort of interventions tend to be much more environmentally focused and system-based, rather individual patient treatment focused.’
It’s a consideration also taken by the PBAC, which flags the need to improve access to non-pharmacological interventions, such as diet and physical activity support.
Earlier in 2025, the RACGP updated its position statement on obesity prevention and management earlier this year, which backs obesity-management medication, including semaglutide-based drugs, being subsidised on the PBS to reduce health inequity.
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