Price talks continue as Health Minister pushes for GLP-1 PBS access

As momentum continues for a push for more affordable access to a class of blockbuster weight-loss drugs, Australia’s Health Minister has given an update on how close a PBS listing is while negotiations continue with leading manufacturers.
 
Interest in GLP-1 RAs has accelerated with little sign of slowing, prompting the Federal Government to work with drug manufacturers to improve patient access – with the RACGP continuing to call for GPs’ role in obesity prevention and management to remain central.
 
Progress on one version of semaglutide (sold as Wegovy) has seen Therapeutic Goods Administration approval for specific weight management criteria, reducing major events in adults with established cardiovascular disease, and provisional approval for severe fatty liver disease, with current PBS listings for a staged rollout of Wegovy for treatment of people with obesity and cardiovascular disease risk.
 
But with no population-wide listing of weight-management medications currently on the PBS and patients paying thousands each year on the private market, Federal Health and Ageing Minister Mark Butler was again questioned this week on the advancements, highlighting that establishing an agreed price remains the biggest hurdle.
 
‘This is a revolutionary class of drugs, and I certainly want to see them on the PBS so that Australians have access to them in an equitable way,’ he said.
 
‘My department has been working with the [pharmaceutical] companies to try and agree a price that they’re willing to receive and we’re willing to pay on behalf of taxpayers – and we haven’t been able to agree that price yet.
 
‘That is the main barrier to getting that first listing onto the PBS.’
 
Recent research reveals around half a million Australians are using GLP-1 RAs, with almost half paying between $200–700 out-of-pocket monthly to access them for conditions other than diabetes.
 
Minister Butler says GLP-1 RAs are ‘too important a class of drugs’ not to have on the PBS and has confirmed his negotiations continue with the two market leaders, manufacturers Novo Nordisk and Eli Lilly.
 
‘There are too many benefits for too many Australians to have it available only to those who are able to find $5000 or $6000 a year for it,’ he said.
 
‘There’s hard work ahead of us, but I’ve made my position clear to the two companies that have these drugs in the market ... and on behalf of the Government and on behalf of Australians that this drug must be on the PBS at some point.’
 
The RACGP’s position statement on obesity prevention and management states that general practice is central to the primary, secondary and tertiary prevention of obesity, and this needs to be continually supported through improved funding of GP consultations to ‘reflect the complexity of the disease process’.
 
However, it also says funding must be directed towards addressing ‘the current inequity in access to effective evidence-based obesity-management services and therapies’.
 
Out-of-pocket costs continue to be a large driver of barriers to healthcare access, and there are specific health equity components of access to medications like GLP-1 RAs, says Dr Tim Senior, Chair of RACGP Specific Interests Poverty and Health.
 
‘It is a clear social gradient that obesity is more common in people who have less money in more socioeconomically deprived communities,’ he told newsGP.
 
‘If we’re serious about managing obesity, including with medication, then we need to make sure the people who are most likely to be affected by it have access to adequate treatment – so that would include access to GLP-1s.
 
‘At the moment, the cost of medication just makes that completely inaccessible for many Australians, and especially those without the money to pay for it. So potentially it would make a good deal of difference for GPs working in those areas.
 
‘The bargaining power of Government is really important for public health here.’
 
However, Dr Senior says it’s important to note the solution is not only improved access to GLP-1 RAs.
 
‘Food security is an issue in socioeconomically disadvantaged areas, access to parkland or nice areas for walking, access to sport and physical activity – all of those are also less accessible in low socioeconomic areas and in many rural and remote communities as well,’ he said.
 
‘We can’t just rely on GLP-1s to do the treatment, we also should be thinking about the health equity components of the environment people are living and working in.
 
‘It’s often portrayed as lifestyle choices, but if people don’t have money or a walkable environment or access to gyms or leisure centres, or healthy, fresh fruit and vegetables – it’s not a choice.
 
‘We can give all the advice we want, but they end up not having a choice if it’s not accessible or available or affordable.’
 
With recent policies enforced by the US Government, price pressures are currently impacting the global medicines market, including a range of medications available in Australia.
 
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