The blockbuster weight-loss drugs have started their path to possible listing on the PBS. Brace yourselves.
As Novo Nordisk drops the price of its GLP-1 receptor agonists, in the US at least, and new concerns emerge about the associated risks to pregnancy and unborn babies, GLP-1s have been added to the agenda of the November PBAC meeting for consideration for PBS subsidisation.
On 6 March this year, federal health minister Mark Butler wrote to the chair of the Pharmaceutical Benefits Advisory Committee to seek the committee’s advice on equitable access to GLP-1 medicines for the treatment of obesity through the PBS.
Public consultation on items to be considered by the PBAC in November is open until 24 September, through the Office of Health Technology Assessment consultation hub.
In Australia, the price of GLP-1s varies depending on active ingredient, use and brand.
Novo Nordisk’s two products are both semaglutide but one (Wegovy) is a higher dose, designed specifically for weight loss. A month’s supply for weight management costs between $250 and $460.
The second (Ozempic) is lower dose but only PBS approved for the treatment of type 2 diabetes. Without a PBS subsidy for weight loss, it can cost about $150 for a month’s supply if prescribed privately.
Tirzepatide, manufactured by Eli Lilly, can cost between $300 and $645 per month.
Liraglutide is also sponsored by Novo Nordisk in Australia, and can cost up to $600 a month.
Novo Nordisk recently dropped the cost of its GLP-1s by half in the US, but its diabetes treatment product still costs the equivalent of about $750 Australian dollars a month.
Meanwhile, Flinders University has published the results of a new study showing that 2.2% of women became pregnant within six months of starting GLP-1 treatment with pregnancy rates highest among younger women with diabetes, and among women without diabetes in their early thirties.
Women with polycystic ovary syndrome were twice as likely to conceive, suggesting that weight loss may improve fertility, even when unintended.
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Importantly, women who were using contraception at the time of prescribing had a significantly lower risk of pregnancy.
“We’re seeing widespread use of these medications among women of childbearing age, but very little evidence that contraception is being considered as part of routine care,” said Associate Professor Luke Grzeskowiak, lead author of the research, published in the Medical Journal of Australia.
“These medications can be incredibly helpful, but they’re not risk-free, especially during pregnancy.
“While the UK advises that women using GLP-1 receptor agonists should avoid pregnancy and use effective contraception, this advice is not being followed consistently in Australian clinical practice.
“We need to ensure that reproductive health is part of every conversation when these drugs are prescribed to any women of childbearing age.
“It is also vitally important that we have clearer practice recommendations and guidelines for those prescribing GLP-1s to women to ensure their safe and effective use.
“Our advice is to speak to your GP about the risks and benefits of GLP-1 medicines before taking them, and only take those prescribed by a healthcare professional.”