THE off-label use of semaglutide (Ozempic; Novo Nordisk) for the treatment of obesity has been blamed for a recent supply shortage of the medication, which is indicated for type 2 diabetes. However, many experts say the satiety medication and others like it are game-changing additions to the treatment armamentarium for obesity.

Demand for the injectable glucagon-like peptide-1(GLP-1) agonist semaglutide has soared in the past 12 months in the wake of a large manufacturer-sponsored randomised trial (STEP 1), published in the New England Journal of Medicine (NEJM), which found once-weekly semaglutide 2.4 mg was associated with an average weight reduction of 15% at 18 months, compared with 2.4% with placebo in people with overweight or obesity.

However, access issues have quickly come to the fore. In Australia, where semaglutide 0.5 mg and 1 mg is approved and subsidised for the treatment of type-2 diabetes, the Therapeutic Goods Administration (TGA) warned in May that off-label prescribing of the drug to people with obesity had caused a supply shortage. Doctors were told to limit prescribing of semaglutide to its approved use in people with diabetes.

The manufacturer, Novo Nordisk, told InSight+ that it has applied for semaglutide 2.4 mg to be registered with the TGA for weight management under the brand name it already uses overseas, Wegovy.

There is also another GLP-1-based medication on the horizon for obesity treatment: tirzepatide. A phase 3 trial published in the NEJM on 4 June found half of patients with obesity randomly allocated to moderate doses of tirzepatide once-weekly lost at least 20% of their body weight at 72 weeks, compared with only 3% in the placebo group. Both groups received intensive lifestyle intervention. The drug has not yet been approved anywhere in the world for the treatment of obesity, although it was recently approved in the United States for type 2 diabetes.

Yet, even if the new GLP-1 agonists become indicated in Australia for weight loss, experts fear their price tag will put them out of reach of most patients with obesity.

Dr Priya Sumithran, an endocrinologist and Group Leader of the Obesity Research Group at the University of Melbourne summarised the hope and concern felt by researchers in the field.

“The last few years have seen a huge change and optimism in the field of diabetes and obesity in what is available and what is going to be possible, and we now have several good treatment options imminent,” she told InSight+. “However, the big question now is whether patients will be able to afford to access them.

“The way we fund or reimburse these medicines will need to change if people are going to be able to benefit from them equitably,” she said.

Access inequity

Patients with insufficiently controlled type 2 diabetes can access semaglutide on the Pharmaceutical Benefits Scheme (PBS) for $42 a month or $6.80 concessionally.

People with obesity, by contrast, pay around $133 a month if they access the drug off-label. It’s a treatment most Australians with obesity – 30% of the population – can’t afford, especially given the high prevalence of obesity among people on low incomes.

Still, many who can afford it will pay, given semaglutide is associated with much greater average weight loss compared with placebo than the medications currently registered for obesity in Australia – phentermine (Duromine; iNova), naltrexone and bupropion (Contrave; Currax), liraglutide (Saxenda; Novo Nordisk) and orlistat. Liraglutide, the only GLP-1 agonist registered for obesity, costs three times as much as semaglutide ($387) and has the inconvenience of being taken daily rather than weekly.

Novo Nordisk, manufacturer of both semaglutide and liraglutide, told InSight+ the two drugs were not equivalent.

“Saxenda (liraglutide 3 mg) is the only GLP-1 approved for use in weight loss in Australia,” the company said in a statement. “Saxenda (liraglutide 3 mg) is a different molecule with different dosing and different indications to Ozempic (semaglutide).”

However, Professor Katherine Samaras, an endocrinologist and researcher at St Vincent’s Hospital in Sydney said the STEP 1 study provided ample evidence to support the prescribing of semaglutide for the treatment of obesity, as many specialists and GPs are already doing.

“Why should people with obesity have to pay three times the cost for a medication when an effective and cheaper medication is available?” she told InSight+.

Professor Samaras, like many of her colleagues, believes the barriers to accessing medications for obesity represent an important equity issue.

However, the Pharmaceutical Benefits Advisory Committee (PBAC) has estimated that subsidising semaglutide for Australians with obesity would cost more than $1 billion annually over 6 years in the current market.

The PBAC considered semaglutide for obesity at its March 2022 meeting and decided not to recommend the requested listing. Doing so would have required “extremely high investment” with “very uncertain implications for the PBS and broader health budget”, the PBAC said.

It also questioned the drug’s long term efficacy on hard outcomes, saying that the sponsor’s modelled reductions in comorbidities with ongoing treatment were “highly uncertain” given no longer term data were available.

Dr Liz Sturgiss, a general practitioner and researcher at Monash University noted that the semaglutide STEP 1 study showed “some improvements in cardiovascular risk factors, like blood pressure, glycated haemoglobin and cholesterol with treatment”.

“Although the trial only reported most of these as secondary endpoints, rather than part of the outcomes, it is promising as it is one of the first trials for obesity medications that are looking at outcomes other than weight.”

She added: “Equity is a major issue in the management of obesity in Australia.”

A disease that kills

Professor Samaras said part of the access problem with obesity medications and also bariatric surgery came down to stigma around the disease.

“There are misleading narratives in the media that people who are obese just want to lose weight for cosmetic reasons, or that they’re to blame for their condition,” she said.

“The fact is, obesity kills people,” she said. “The major cancers in Australia today all have obesity accelerating them, and obesity is a risk factor for diabetes, cardiovascular disease, fatty liver disease and cirrhosis and arthritis.”

Professor Samaras criticised a “monocular glucocentric view about obesity”, saying many people who were obese maintained normal glucose levels but had significant obesity-associated comorbidities or were at risk of them.

Even modest reductions in weight could relieve significant health burdens, Professor Samaras said. For instance, a weight reduction of 5 kg might assist some patients in their blood pressure and lipid management.

Other patients may have greater weight reduction goals to access interventions such as cardiac transplantation or to ensure good outcomes following cancer therapy or joint replacement, she said.

The place of medication

Professor Samaras said new GLP-1 agonists were good additions to the treatment armamentarium for obesity, alongside lifestyle interventions and if necessary, bariatric surgery.

“For people who’ve already tried diet and exercise again and again and again, you add in whatever is necessary and safe, commensurate with the impact of obesity on that individual,” she said.

Bariatric surgery now had 20-year outcomes reported in the literature; however, with almost no access to the surgery in the public system, it too was out of reach to many patients, she said.

Professor Samaras said GLP-1 agonists should be considered before a trial of bariatric surgery.

The new medications could also be useful for people who regained weight in the years after successful bariatric surgery, she said.

Evidence was also accumulating to support the use of GLP-1 agonists to mitigate the obesity-inducing effects of antipsychotic medications, according to Professor Samaras, who is involved in a trial co-prescribing semaglutide and clozapine.

Professor Samaras stressed that no medication or surgery would work without lifestyle change.

This was actually one of the PBAC’s reasons for not recommending the listing of semaglutide for obesity – it was “unlikely” that the benefits of semaglutide seen in clinical trials would be “fully realised in Australian practice without the intensive diet and exercise counselling co-administered in the trial program”, the PBAC said.

Risks and contraindications

The main side effects of the new GLP-1 receptor agonists are gastrointestinal – nausea, diarrhoea and constipation.

In the semaglutide obesity study, 4.5% of participants in the treatment arm discontinued treatment due to gastrointestinal events.

Professor Samaras commented: “Some people can be exquisitely sensitive and may take the lowest dose and vomit for one week. They might respond better to a different medication.”

There are also questions about the safety of GLP-1 agonists in the context of significant alcohol consumption given the small risk of pancreatitis, Professor Samaras said. However, she added that, anecdotally, semaglutide could actually reduce a patient’s interest in alcohol.

Professor Samaras said the biggest concern with the new drugs was the lack of long term safety data. The longest follow-up period is only about 3 years for semaglutide.

“However, one needs to remember that obesity itself is not a benign condition,” she added.

In general, NPS MedicineWise notes that there is no legal impediment to prescribing medications off-label, but the onus is on the prescriber to defend their prescription for an indication that is not listed in the product information.

A spokesperson for the TGA said the shortage on semaglutide is expected to resolve on 31 August 2022.

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Poll

Drugs such as semaglutide should be available on the PBS for both obesity and diabetes
  • Strongly agree (85%, 1,478 Votes)
  • Agree (8%, 135 Votes)
  • Strongly disagree (3%, 47 Votes)
  • Disagree (3%, 45 Votes)
  • Neutral (2%, 32 Votes)

Total Voters: 1,737

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43 thoughts on “Accessibility, cost of game-changing obesity drugs problematic

  1. Anonymous says:

    See the updates on the TGA website as at 04-AUG2022:
    Ozempic supply is not due to resolve until DEC-2023
    Per joint statement issued by manufacturer Novo Nordisk plus others.

    I fear they’re basing the ability to meet supply at that time based on T2D prescriptions, and/or ‘current’ order attempts.

    Until July 2022, some compounding or single site pharmacies seemed to have ongoing limited success W a strategy of ordering one or two units at a time servicing a mixed indication client priority list long as your arm:
    So, official demand in no way represents actual demand for Semaglutide. *sigh*

    In response to Comment 3. Dallas:
    Yes, anecdotally (fellow patient here, but prescribed specifically for same) highly effective against weight gain, peripheral swelling, joint inflammation and other metabolic effects of an SNRI (Effexor i.e. venlafaxine).

    Lost all the pharmaceutically-induced weight gain,
    12kg in first 3mths on GP-supervised VCLD + mandatory “programme” – as though my attitude to hunger and nutrition had anything to do with a known drug side-effect. (30kg gained over 15 mths=> Lost 32kg over 40 mths, initially on Saxenda then switched to Ozempic when it became available.)
    Reduced side effect profile and more effective for lucidity for me, anecdotally. @ prohibitively expensive 2mg per week, $275/mth.
    Returned to very slow weight loss on a normal diet ~1500-2000cal/day for last 15 mths because close enough to my lifetime normal weight in healthy range to mitigate obesity-mediated health risks and didn’t want an apron of flaccid belly skin.

    Comment 4. Higher dose injectable Semaglutide may be up for application/assessment? (1.7mg, 2.4mg etc. Wegovy), BUT I don’t see it on ARTG, PBS, or TGA websites.
    HOWEVER, Rybelsus as tablets recently ARTG approved….

  2. Michelle says:

    The fault for disruption of supply of Ozempic is 100% the responsibility of Novo Nordisk. They claim it is because of viral tiktoks. However, people only began using Ozempic for weight loss because of Novo Nordisk’s own drug trials looking at Ozempic specifically for weight loss. If they had never mentioned this, it would have taken much longer for stories about weight loss to have made the media.

    Novo Nordisk are blaming obese people to distract from it being THEIR fault.

    The TGA has NO RIGHT to be commenting on a medication being legally prescribed by a doctor for their patient. The benefits of asprin for heart disease patients was discovered by accident and not the intended – or approved – use of asprin, yet once it was known, this use became widely accepted and recommended – without judgement about the morals of heart disease patients. The TGA is overstepping their responibilities and the media release they did in May, inferred obese people were lazy and slobs for wanting a medication to assist where all other efforts have failed. Even bariatric surgery has failed people, the lap band alone has an eventual 100% failure rate.

    Ozempic is a new medication, we don’t know the full benefits or harms it will eventually do. What we do know is it is helping people with a variety of things, some intended (diabetes) others not (weight loss). A list of drugs found to be beneficial for conditions they were not developed to help include, Lithium, Cortisone, Rogaine, Viagra, Tamoxifen, AZT, Valium, Ipronizid, Botox, Warfarin, Nitrous Oxide, Thalidomide, Raloxifene, Rapamycin, Lomitapide, Pentostatin, Sodium Nitrate, Disulfiram, Cisplatin and Propecia.

    None of these were approved for their current uses before they were discovered to also help in these areas. Ozempic is not new in this regard, yet is being used as an easy way to attack obese people for needing it, because of the chronic social stigma around being overweight in society. The obesity market is huge, you would think Novo Nordisk would welcome an increased customer target.

    No one wants to take medications if they don’t need them. Obese people are not looking for an easy fix or to avoid a lifestyle change, listening to people who have eventually been able to shed unwanted weight either through drastic change or medical intervention, shows us with weight loss comes improved lifestyle, including better diet and more physical exercise. Ozempic is not an ‘easy out’, it is a bridge that helps people be able to get there. It is time for people’s prejudices to stop killing people.

  3. Margaret says:

    I also think that whoever needs this type of medication should have access to it at an affordable cost without feeling judged. I’ve heard there should be good news with a new type of GLP becoming available in 2023 called Tirzepatide. Hopefully that will be priced somewhere where those that need it can afford to pay for it or at least cause enough of shake up that the other brands may come down in price.

  4. Dallas says:

    I take Mirtazapine for depression and I cannot sleep properly without it.

    I wonder if this drug could help me lose weight, along with my general diet and exercise plan?

    I wonder what the overall cost to the government would be to treat me for a heart attack l, or even worse still, put me in a home because half my brain is missing due to a stroke?

    I bet it would cost a fortune. But prevention is better than cure or treatment, isn’t it? What if, due to the medication I must take to sleep and not be suicidal, that I am much more likely to be obese and suffer health problems if that obesity isn’t dealt with?

    Does the government really understand the stupidity of not allowing those with a BMI over 28 affordable access to this drug?

    Anyone with elevated triglycerides or other markers for serious health problems and who has a BMI that is considered quite obese should, along with diabetes sufferers, should be given affordable access to this medicine!

  5. Phyllis SMITH says:

    In 1966 I was diagnosed with lupus sle, was on prednisolone +plaquinel every time I had a relapse I was 13yrs of age and was 9st to start it was not explained about the weight gain with the prednisolone, after 6mths on prednisolone then weened off it over 6wks,my weight ballooned to 13st, I was put on a 1000cal diet no carbs the diet sheet I was given was so strict. I lost 4st in 3mths and that was the start of my battle, with the bulge, I seriously thought when I lost all that weight I wouldn’t gain it again I would be so careful, when 9mths later I had another attack and so it went. Now 56yrs later I am still battling the bulge ,at 69yrs of age, due to my yo-yo weight I now have fatty liver ,cancer, rheumatoid arthritis, glaucoma high bp, was prescribed ozempic for 6mths until it became unavailable that was 3mths ago, my Dr told me about wegovy, I could pay $140,a mth but. Not the full price. Just when you think a miracle,cure is here it’s snapped away because of money.

  6. Anonymous says:

    Really tired of obese people being treated as a cash cows. I would happily use Saxenda but the cost is way to much $400 a month how can that be justified. No one wants to take drugs from diabetics but make alternative comparable in cost per month. Obesity is a disease and we should be given the same access to drugs that can assist. At $133 per month private script for ozempic for weightloss to treat just as deserving morbidly obese .

  7. Nichole says:

    Everyone deserves a chance to survive weight is a genetic condition not just a eating problem lipoedema n lyphedema is painful n causes stress this causes weight gain if this medication could help anyone cope with their condition of weight then help them help themselves where did humanity go honestly’ healthy foods are through the roof in prices n medications to somewhat help cost a body part. I live with this painful condition of lipoedema n ozempic is helping me n I pay full price’ give those who can’t the chance to change their life too n have options available to avoid surgery..,,

  8. Anonymous says:

    I think ozempic should be available for everyone if it’s going to improve your health

  9. Anonymous says:

    I think that you should only get it if your BMI is high I have had my thorid out on blood pressure tablets and I have lost 15 kg so far sw 128 GW 88 I wish it was cheaper doctor’s should only give it if you have a lot off weight to loose

  10. Anonymous says:

    I have always struggled with my weight most of my life , I work out and walk and do intermittently fasting .. I started ozempic as my drs advise to start as I was close to d2 as it runs in my family . Now after 3mths of being on it my dr was so surprised and happy I was heading in the right direction. Unfortunately now that we are not allowed to get our script filled as we aren’t D2 is so disheartening for all of us that what to better our health and prevent it in not going to that stage of d2.
    This is not and should be not declined for people that have weight life obesity and want to lose weight , we have being deemed upon the society as we want a quick fix .. and it’s now discriminating against people like us . Isn’t prevention better that doing nothing and waiting until we get d2 , which then will cost the government more in the future . The cost of the other drug saxenda is absolutely unaffordable for most us .
    The government should really listen to the people and other medical experts on this debatable issue we are having . USA and every other country are using it for both weight loss and D2 . So why can’t our government add it on pbs for weight management.
    It’s causing anxiety for all off us that are going threw this . For me it was a life changing thing , my anxiety , depression and health changed dramatically. Now what can I look forward too , when I see this injustice happening in our society

  11. Josie Francis says:

    It was placed on the market to help diabetics, which I am one of them and nownin desparate need to be able to fill my scripts. When they can quarentee the supply for the diabetic family then and only then should allow to the general public.

  12. Anonymous says:

    My Heart Specialist prescribed Ozempic for me as after having two bad falls and not being able to walk properly for 5 months and even though i am a healthy eater I could not rid the extra weight because I couldn’t exercise properly and then Covid arrived!! The weight got worse from depression and waiting nearly two years for more surgery to be done on my leg and arm I was at a loss!! I was diagnosed as pre diabetic and also had a stent placed in my heart form a blocked artery!! Obesity was killing me!! This drug should be on the PBS to cut down all the health problems that come from Obesity!! If the people can get this drug to help them get healthy it will save the Government millions of dollars!!

  13. Anonymous says:

    I’m at high risk of developing T2D due to PCOS and insulin resistance. I have lost over 10% of my body weight and the most incredible thing to come from being on Ozempic is the improvement in my reactive hypoglycemia. I used to have hypos daily and I was needing to eat every 2 hours. I felt as though I was stuck on a glucose/insulin rollercoaster and I didn’t dare leave the house without carrying a supply of snacks. Like others with RH, I then developed anxiety and panic attacks from the fear of the next hypo. Ozempic has balanced out the highs and lows and been life-changing in this regard.

    I’m concerned prices will increase further when Wegovy is approved. Ozempic is inaccessible for many as it is. And many will be priced out of their current treatment if forced to switch to Wegovy and pay the Saxenda-like prices.

  14. Anonymous says:

    With the JAMA study showing re-gain of weight when switched to placebo, clarification about the duration and long term plans of treatment will be important for clinicians. Is this a short to medium term or lifelong treatment?

    Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., … & STEP 4 Investigators. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. Jama, 325(14), 1414-1425.

  15. Anonymous says:

    I’ve struggled my whole life with weight issues that have affected my self esteem, mental health and mobility. After a car accident 2 years ago, I put on 35kg due to pain and immobility. Ozempic has assisted me to lose 10kg over 12 weeks that diet and mild exercise alone could not achieve. This 10kg reduction in weight has decreased the pain I felt exercising and I can now walk up to 5km a day (before Ozempic, I could only manage 1-2km). So Ozempic is helping not only with my weight loss but also my capacity to exercise and work towards losing/maintenance in the long run. I am so sick of being treated as a second class citizen because society perceives my weight as being my fault. We have to get over the blame game and move on to positive treatments that work. I would like to know have I can impact on making the government move forward with this issue?

  16. Anonymous says:

    I am 69 with a history of obesity, high blood pressure, high Cholesterol and a family history of type 2 and type 1 diabetes… This drug may help me live longer by losing weight and spend more time with all my beautiful grandkids. I do believe that if Ozempic was on the PBS for obesity the overall long term savings and benefits would definitely outweigh the cost of subsidising Ozempic and this needs to be taken into consideration.
    What is better…saving ones life by helping those with obesity to lose the weight and not have as many hospitalisations or having to take multiple prescription drugs to control the comorbidities that come with Obesity or just going along like we are now and not doing anything to help those that need it…..I think Commonsense should rule and we help those with obesity and stop the strain it puts on the hospital system and paying out for the drugs that may be stopped because that person has lost the weight that causes them.

  17. Anonymous says:

    Subsidising this drug for weight loss would cost the PBS $1 billion a year. When there are so many examples of Ozempic being used for vanity weight loss on the FB groups — people with less than 10 kg to lose who can’t be bothered changing their lifestyle habits — then there needs to be strict regulation to subsidise it for people who have not been successful on calorie deficit diets and are at higher risk of negative health outcomes without weight loss. It shouldn’t be for people who literally want to have their cake and eat it.

  18. Anonymous says:

    I am encouraged by the stories on here about people using Ozempic for weight management. Like a few others, I have had a large weight increase due to the effects of other, life-saving medications. I have been on-off Saxenda for about a year now, and combined with intermittent fasting, focusing on diet and exercise have lost about 16kg. I won’t lie. The times when my budget dried up and I couldn’t afford Saxenda made continuing with the intermittent fasting more challenging, but not impossible. Like someone else on here, I need to have two knee replacements and possibly a hip replaced also. But they have said they want to wait until I am older for those operations because of obsolescence. Of course, this makes weight bearing exercise, such as walking on the treadmill (which I prefer), harder. I am on constant pain relief. So to say that my journey is a simple, or easy one would be misrepresenting the facts. If Ozempic at $133 a month were made more readily available even off-label for obesity patients would literally be a lifesaver. I rely on government benefits, and have to take out government loans to afford Saxenda. Please, Australian government, hear our pleas and do something to remedy the situation. Make Ozempic available to obesity sufferers. It will take a huge weight off the Australian health care system, too..

  19. Anonymous says:

    I have a muscle disorder so exercise is hard… no it’s virtually impossible. I’ve slowly put on 30kg over the years and have developed blood pressure and have a aortic aneurysm – thanks to the weight. My heart specialist prescribed ozempic in March and I’ve lost 14kg in 12 weeks. I:be lost enough to go off the blood pressure medication and my burdened muscles are no longer exhausted from just moving around my house. Without ozempic I was dying of weight-related illness. With ozempic I have a future – much the same as somebody who has been prescribed ozempic for diabetes has a future.

  20. Anonymous says:

    I have been diagnosed as a T2 diabetic and prescribed on Ozempic- for insulin control and weight loss, but my reading was .1 under the levels required to get PBS subsidy for Ozempic, glucose monitor and strips. As a person working part time on a low wage. This is a huge access and affordability problem for me. If you are diagnosed with T2 you should have access to the PBS subsidy.

  21. Anonymous says:

    Oz should be available. I have seen some people only 10 to 15 kg have bariatric surgery which brings higher risks than being on this drug .
    Surely government and TGA must see the benefits to all using it and make it available sooner the better for us all.

  22. Anonymous says:

    Initially I was put on Ozempic to lower my weight as I’m on medication for high blood pressure, tremors and anxiety and pain. I have a genetic condition Fragile X that is the reason for my medical issues. I’m at risk for falling and by losing some weight would make it easier should I fall for someone to help me up. At no point did I think Ozempic would change my life in the way it has. To my surprise and those around me I not only have lost weight but my tremors have reduced significantly. I was mostly bound to home due to the severity of my tremors in every part of my body. It hasn’t cured them but compared to the actual tremor medication I’m on it has allowed me to participate again in life. Had this not been offered to me I’d still be housebound. Taking away my obesity I would never know how life changing this could be for me. Yes it’s not cheap and I’m on benefits but worth it to get some relief from the intense tremors and constant muscle pain I was in 24/7. What I have is progressive but there is no denying the benefit I have for however long that lasts.

  23. Anonymous says:

    This medication not only for weight loss but also assists with symptoms associated with PCOS has been a godsend for me there is not a lot of medication to help PCOS

  24. kirsti Lee says:

    I am not a medical professional but I want to share my story because the stereotyping needs to stop. Some, possibly most obesity is not preventable or reversible without medical intervention because it is not directly caused by the sufferers actions but by factors beyond their control. In my case the cause is hormone related.
    After putting on weight steadily for over 10 years because of a hormone imbalance that wasn’t treated correctly, I developed hypertension, pre-diabetes, fatty liver, rosacea, repeated conjunctivitis, constant cold sores, tendonitis that wouldn’t heal, plantar fasciitis, alopecia, oedema, menhoragia, heartburn, fibroids, insomnia, anxiety, depression and anemia. All of these have been labeled as metabolic syndrome and attributed to the hormone imbalance and subsequent weight gain.
    I have always been fit and healthy until this happened to me. This was caused by a hormonal birth control iud.
    I fought and advocated for myself for years to identify and treat the cause of my deteriorating health and I managed my diet and exercise meticulously for all but a few weeks in total over the entire 10 years.
    Until I was prescribed ozempic in January this year, my weight was increasing gradually every week regardless of my diet and activity level and even though my hormone imbalance had been corrected for at least 18 months already and my body had stopped converting any muscle I built into fat cells.
    Since ozempic I have lost 12.7kg of the 39.5kg fat I had gained and my blood pressure is almost normal, my skin conditions and other health issues have either gone or improved to the point where they are no longer impacting my daily life.
    The interesting fact here is that I still eat almost the same, in fact not as carefully as before and I now have regular treats like a piece of cake or chocolate. Things I never allowed myself before ozempic. Despite the treats, I am still losing weight and improving my health. I was sick for over 10 years until I was prescribed ozempic. Now I am being told I don’t deserve the only medicine my doctor has found that helps me.
    That PBAC has decided to justify the denial of this necessary and effective medicine for those who need it based on out-dated and disproven diet and exercise ideas is concerning. How qualified are these people really to be determining the health outcomes of an entire country?
    Why do they think it’s ok to keep us sick?
    Is it because their training is so outdated that they actually believe obesity is purely caused by overeating? Have they missed all the new stuff discovered in the last 20 years about hormone balance, genes and gut health?
    If it’s poor diet that is the sole cause of obesity, then why not place a levy on every food that contributes and use that money to fund the treatments. Provide better reduction on nutrition in schools!
    Did they factor in the extra taxes available when healthy people go back to work?
    If the numbers for funding ozempic for a very small portion of t2 diabetics can stack up, then they also must for obesity and the multitude of health issues that causes because they are greater in number and therefore greater in benefit.
    I believe my health needs are as valid as someone with t2 diabetes and I am not ok with being discriminated against because I have fat.
    Especially when it was caused by an approved medication in the first place!

  25. Anonymous says:

    It’s time the PBS stopped looking at morbidly obese people as cash cow’s. The cost to the economy long term would be better than treating people with more complex issues than affect the prospects of employment, further underlying medical conditions including cardiovascular disease, joint replacement and not to mention mental health outcomes. As a person who has high dose mental health medications, no Super that I can call on to use for bariatric surgery and no prospects of getting public health assistance due to my age this would certainly help if it was subsided and done in conjunction with a dietician or multi facet team. The cost alone for a pensioner off label is not practical, especially with the cost of living just to keep a roof over one’s head. I hope they look at the ramifications of denying people cost effective treatment, however I don’t believe young people or those who need to lose 10kg or less should be prescribed unless they have some major underlying condition. It should be about education, healthy lifestyle changes and exercise before using this. Unless a person changes their mindset and lifestyle you can use medication and surgery, but it will ultimately fail if you are not educated and make the appropriate changes.

  26. sam snell says:

    suffering pocs and major depression my medication made me ballon to 106 kg I started taking sexenda but the price sky rocketed to $500 pm just unaffordable. so I’ve started taking ozempic both my parents have diabetes with pocd I’m next I’ve lost 20 kg and I’m just maintaining now this is life changing and should be avalible for all

  27. Kim Carson says:

    After being told at 32 after the birth of my 1st baby that I needed 2 new knees BUT they will NOT do them until I’m 60/65 I won’t lie I struggled and NEVER thought I would lose my gained baby weight. All the diets in the world were not helping because I couldn’t exercise and when I did ‘push’ myself to go for a walk with my girls or take them to the park, I would be in pain and couch bound for days. I started on Ozempic in February at 96kg and today I weigh around 80kgs, my knee pain is manageable and some days I have NO knee pain AND my girls&I are soooooo much more active and life is good. I thank ACA for airing their story on Ozempic for weight loss in February because it honestly changed our lives. I’m a single, stay at home mum of 2 girls 9&6, the cost is a killer but I will make sure I budget it in because it WORKS, my doctor prescribed me duromine which also cost around the $130 per month which I was on for 3 months prior to Ozempic and I never lost a single kg so I’m much happier paying the money for Ozempic

  28. Anonymous says:

    I had used Ozempic for several months for weight loss, losing about 10kg until supplies dried up. I stopped using it so there would be more available for diabetics, but had wanted to return to using it once the supplies issues were stable again. Like many other people, I am still considered obese with much weight to lose.

    Obesity is a medical condition which can now be treated, but when it is untreated causes other issues. Surely if the government approves use of it and puts it on the PBS the country as a whole will be overall healthier, and therefore the hospital system will be better off? Healthier bodies don’t need as much health care.

    I am pre-diabetic, and I was really working towards having healthy blood sugar levels. I eat smaller portions now, and still don’t feel like alcohol r chocolate, but I have more weight to loose and hike taking Ozempic I was much better off..

  29. Anonymous says:

    To Anonymous at 9:33 am. Whilst research is needed anecdotally I am seeing excellent results in Type 1 diabetics. For example when on 0.5mg / week of semaglutide my patient (who is on a closed loop system) went from time in target of 60% to almost 90% and insulin units per day from a a variable 60-72 units per day to reasonably consistent 42units. Also during an 8 week period almost 5% body mass loss. As she is not T2 she does not qualify so purchases it on a private script.

  30. Anonymous says:

    I was prescribed Ozempic for obesity in a major hope that I wouldn’t develop diabetes. So why is there; or should there be, any difference in the price paid or a shortage or non supply of the drug for people who are hoping to lose weight in order to hopefully delay the onset of further issues that would result in the use of the same medication. I just don’t get it. I am too scared to start using the medication I paid a huge amount of money for if I can’t continue to use it as my doctor would like me to.

  31. Ms Brown says:

    I use semaglutide off-label @0.5mg for weight loss and appetite training. There are gastric side effects but I find them manageable. However there are other side effects that I am greatly appreciating. Some other users report similar outcomes.
    1. anti-inflammatory. The psoriasis I developed following cancer treatment 2 yrs ago has gone. My skin is obviously better and my joints feel more lose. My physique feels less puffy even though I haven’t lost much weight (3% over 2.5 months, still obese).
    2. mental health. A certain type of anxiety, like a mild but permanent yearning or discomfort, has disappeared. I feel more confident in myself in the moment.
    3. Both points 1 & 2 have made exercise easier to undertake and therefore more enjoyable. Win.

    As semaglutide users will tell you, it is not a magic bullet. You have to consciously make changes to your relationship with food and eating. Semaglutide makes that easier but it won’t do it for you. Mindful eating and activity is vital so when one goes off the drug, appetite is more manageable.

    I am personally OK with paying non-PBS prices for semaglutide because I can afford it and private cover returns about 40%. The remainder is offset by the money I save in food (bringing smaller leftovers rather than buying whole lunch, etc). I think it should be on the PBS for some obesity treatments, but not as a general first option treatment. Helping people get to a healthy level for necessary surgery for example – specific purpose for a limited time. But make it the 2.4mg dose pen for more proven efficacy.

  32. Anonymous says:

    I have been on ozempic for 14 weeks with a total loss of almost 20kgs. This has changed my life. Being obese is a disease and I probably would have ended up with diabetes as I was pre diabetic. I’ve slogged my guts out exercising and eating healthy but was still grossly overweight. Ozempic should be available for weightloss to stop this terrible disease.

  33. Anonymous says:

    Not only am I obese, I have disordered eating, Ozempic helps control my eating habits.

  34. Ms Crankypants says:

    Obesity is a pandemic in itself. Surely the government must see benefits in spending a little to save alot later.
    Instead of having a huge wait list of “free” weightloss surgery for those who meet the strict criteria, maybe there could be a smaller fee for those unable to pay or without adequate superannuation.
    While these drugs can be literally lifesaving, their long term affects are unknown. I feel they are also being abused by some people wanting to drop a few kgs. I have taken part in groups where people have claimed they “need” to lose 7 or 10 kgs because they are only X amount of CMS tall. True obesity is not 10kgs over your ideal BMI.
    Another falsehood is people who are obese are just lazy overeaters, not always the case, there are so many factors, genetics, medications other medical conditions.
    If doctors can reliably and strictly determine those who are genuinely needing the medications or surgery a little outlay will reduce the blow out later on of mobility issues, joint replacements, osteo arthritis, possible cancers, people possibly requiring to be in care at younger ages, the list goes on. Every person deserves to live their best life.

  35. Aussie Kate says:

    Obese people deserve help to avoid other illnesses due to being overweight. Why shouldn’t they have access to Ozempic? Everyone should be able to have access to medications if it means they will attain a healthy BMI, The manufacturer should increase the supply, after all, they are making money on their products, it’s a win win situation all around.

  36. Anonymous says:

    Your quote that tirzepatide is a GLP 1 medication is wrong. That is not the class of medication it is. It’s a GIP. It’s hard to take an article seriously when they don’t even have their medical facts straight because you’ve put a medication in a completely wrong class

  37. P Langton says:

    People seem unaware that the PBAC considers the cost effectiveness of new medications/indications.
    The simple fact is that current GP-1 agonists for obesity do not (yet) have data to show cost-effectiveness, despite Australian having one of he most generously funded public medication access systems.
    For those advocating a $1B spend on these agents, please either (1) ID equivalent cost savings (hint, PBAC already looked for these & couldn’t find them; &/or (2) nominate other health funding that can be repurposed for GLP-1 agonists.
    And if you want to argue that we should be much more generous in PBS funding, I can immediately find another ~$10B of potential spend on agents more effective than GLP-1 agonists for obesity.
    Cost-effectiveness should remain the primary consideration of the PBAC, and side arguments about equity & accessibility are a red herring.
    I’d be much more interested in seeing my tax $$$ spent on funding bariatric surgery, which has consistent, peer reviewed, published long term health outcome data – … but not so much support from TicTok & Instagram Influencers.

  38. Anonymous says:

    It should be made available for Obesity and Diabetes without any debate and under the PBS scheme.

    Saving lives is saving lives!

    If Obesity is a leading cause of disease and death for some and this drug is a real game changer – it shouldn’t be denied anyone.

    I have read of some doing 1400 calorie diets for years to no avail or some doing low carb diets only to find menopause is against them or even their thyroids.

    So, it isn’t always about unhealthy attitudes or diets, but at times changes in the body and age plus a high level of intolerance to carbs even if minimal.

    For example, a person might be on 1400 calories a day, but if any of that is a high carb then it may hinder any weight loss whatsoever. E.g. Bananas.

    From what I have read Ozempic seems to be able to unintentionally bypass menopause, thyoid issues and all kinds of metabolic issues, but not without its own negative consequences like constipation, nausea and diarrhoea. However, some learn to tolerate it and some eventually get over those initial symptoms. Some just don’t!

    But it does work for most and that is important to know.

    If it can deal with Obesity effectively and even prevent it then it is something that should be made available 100%.

    Also, sooner rather than later!

  39. Anonymous says:

    Excellent commentary by Professor Samaras. The PBAC statement that the STEP results are unlikely to be achieved in Australia without the intensive lifestyle intervention simply reflects the prejudice of the establishment against obese individuals. Lifestyle interventions were undertaken in both groups in the trial and have already failed to provide long term benefit in these patients.

  40. Ann O'Nymous says:

    I used semaglutide 2mg/week off-label to complement LGS and shed a further 12kg in 7 months. It is a ‘game-changer’ and I cannot wait until a reliable supply is once again available in Australia. I take no other prescribed medications, have no significant family medical history, and am more than happy to bear the cost of semaglutide as I feel it will help to prevent future health problems/costs.

  41. Anonymous says:

    Agree with Adrian Clifford’s comment. PBAC says drugs would cost 1 billion over 6 years. What are the health costs of untreated obesity over that period? I also remember when Cimtetidine or Omeprazole were considered too expensive by some! In the recent NEJM paper, Tirzepatide resulted in an 8mmHG drop in systolic BP in essentially people with no or treated hypertension. 39% lost more than 25% body weight in 72 weeks. That compares pretty favourably with bariatric surgery without all the serious adverse effects and costs. Mind you, I wonder what the reduction in food intake will save the person paying $133/month, especially with current lettuce costs.

  42. Adrian Clifford says:

    On a comparison cost basis, what is the cost of morbidity and illness from obesity compared to the cost of a drug which can reduce obesity effectively?

  43. Anonymous says:

    Why would you use this drug for Type 1 Diabetes? Perhaps the question is incorrect.

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