Across Australia, weight-loss medications known as GLP-1 agonists are increasingly recognized as a critical treatment option for individuals with severe obesity, yet access remains limited due to the absence of public subsidies. In hospitals and clinics, medical professionals are confronting significant challenges managing patients whose conditions — including extreme body weight and related complications like kidney failure, heart failure, and type 2 diabetes — severely impair mobility and quality of life. Despite proven effectiveness, these drugs are largely accessible only through private prescriptions at substantial cost.
Endocrinologist Dr. Kathryn Williams, conjoint senior lecturer at the University of Sydney, highlighted the clinical urgency faced by patients with body mass indexes (BMI) above 50 who suffer from functional impairments such as difficulty walking, breathing problems, and isolation. Many of these patients cannot afford GLP-1 agonist medications, and current treatments involving diet and exercise alone are often insufficient for individuals with very high BMI.
Dr. Williams and other specialists have long advocated for the inclusion of GLP-1 weight-loss drugs on the Pharmaceutical Benefits Scheme (PBS), which would provide subsidized access for patients with severe obesity. However, negotiations between the federal government and manufacturers have stalled. Novo Nordisk’s Wegovy, a GLP-1 drug recommended for listing by the Pharmaceutical Benefits Advisory Committee nine months ago for patients with BMI over 35 and established cardiovascular disease, remains unavailable on the PBS due to unresolved price and patient cap agreements. Similarly, efforts to list Eli Lilly’s Mounjaro for type 2 diabetes failed earlier this year, forcing an estimated 400,000 patients to pay upwards of $600 monthly out of pocket.
The government’s insistence on risk-sharing agreements that limit the number of subsidized patients has been cited as a factor in the impasse. Officials require manufacturers to bear costs if patient caps are exceeded, raising concerns about potential overuse and budget impact in a market where hundreds of thousands are already accessing these medications privately.
Globally, several countries—including the United States, France, Iceland, Japan, and the United Kingdom—have implemented various levels of subsidized access to GLP-1 drugs for obesity, often linked to cardiovascular risk factors. While public insurance schemes in the US cover these medications in select states, Australia’s system has yet to follow suit, despite the nation’s high obesity rates—second only to the US worldwide.
Dr. Williams described the situation as an unprecedented barrier to practicing evidence-based medicine. “It’s actually really confronting as clinicians because we can’t prescribe people these medications that they need. It’s become this massive social issue,” she said. Without subsidized access, many severely obese patients remain without effective pharmacological options to manage their condition, compounding inequities in chronic disease treatment.
With weight-loss drug sales projected to reach $113 billion globally by 2030, driven largely by GLP-1 therapies, experts urge policy change to address the urgent health needs of Australians with severe obesity. Whether through PBS listing or alternative programs, medical specialists emphasize that timely availability of these treatments is essential to reduce the burden of disease and improve outcomes for this vulnerable patient group.