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Weight-loss drugs are set to be subsidised by the federal government for the first time, but only for patients with obesity who have established heart disease.
In a long-awaited decision published on Friday, the Pharmaceutical Benefits Advisory Committee recommended that semaglutide, sold as Wegovy, be subsidised for patients with obesity and heart disease who have experienced a heart attack, stroke or have symptomatic peripheral arterial disease.
Pharmaceutical giant Novo Nordisk has applied for Wegovy to be included on the PBS twice previously, both of which were rejected. Credit: Bloomberg
The move lays the groundwork for weight-loss drugs to be subsidised for more patients with obesity.
While this class of drugs is currently only subsidised by the Pharmaceutical Benefits Scheme (PBS) for the treatment of diabetes, thousands of Australians are using them for weight loss, paying up to $400 a month for private prescriptions.
The committee recommended limiting PBS access to high-risk patients who have a BMI of 35 or higher, or 32.5 or higher for patients of Asian, Aboriginal or Torres Strait Islander ethnicity.
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It pored over evidence from a large clinical trial, funded by the drug’s manufacturer Novo Nordisk, involving over 17,000 people who took semaglutide alongside their usual heart medicines.
The trial found this cohort of patients had a lower chance of having another major cardiovascular event, such as a heart attack, compared to those who took usual heart medicines only.
Professor Jason Kovacic, a cardiologist who is the chief executive of the Victor Chang Cardiac Research Institute, said the trial had provided the evidence he needed to prescribe semaglutide for his own patients.
Kovacic said the recommendation was welcome news, but subsidies should be considered for patients who have not had a serious cardiac event.
“It’s always unfortunate to tell someone that they’re not eligible because they’ve not yet had a heart attack or a stroke,” he said. “We’re in this era [when] overweight and obesity is a treatable risk factor … there’s still a broader group that benefited in the select trial that aren’t going to be eligible.”
The committee estimated that, based on the trial results, for every 1000 people treated with semaglutide over 3.5 years that also had a BMI above 35, there would be 39 fewer major heart events and four fewer deaths compared to those who did not take the drug.
It is not known how many Australians will benefit from the proposed changes, but an estimated 13 per cent of the population lives with severe obesity, defined as having a BMI of 35 or above.
A Novo Nordisk spokesman said the decision recognised the importance of addressing cardiovascular risk in people with obesity.
They described it as “an important first step toward securing more equitable access”.
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The pharmaceutical giant has unsuccessfully applied for Wegovy to be included on the PBS twice previously.
A federal government spokesperson said the Department of Health would work closely with Novo Nordisk to ensure all requirements were met to progress the medicine to PBS listing.
Dieticians Australia chief executive Magriet Raxworthy said people experienced significant health benefits from semaglutide when it was appropriately prescribed and supported by dieticians.
“Dietitians Australia continues to call for safeguards to ensure that anyone prescribed weight-loss medicines for any purpose is also supported with access to a dietitian,” she said.
She said the drugs suppressed appetite, and could lead to malnutrition, loss of muscle and bone mass and disordered eating.
The World Health Organisation (WHO) earlier this month urged governments to make GLP-1 medicines such as Wegovy more affordable, recommending their use for weight management in adults with obesity, alongside traditional interventions such as exercise, diet, and counselling.
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