An estimated 450,000 Australians will miss out on discounted weight loss medication after pharmaceutical giant Eli Lilly declined a recommendation to have the government subsidise its Mounjaro drug for people with Type 2 diabetes.
The Pharmaceutical Benefits Advisory Committee recommended on Friday that tirzepatide, a once-weekly injectable medication sold as Mounjaro, be subsidised for adult patients with inadequately controlled type 2 diabetes.
“The PBAC acknowledged the clinical need for additional effective treatment options for people with type 2 diabetes mellitus, noting that a proportion of patients do not achieve adequate glycaemic control with currently PBS-listed therapies,” it said in its recommendation.
“The PBAC noted that tirzepatide is currently available through the private market and considered that PBS listing would improve equity of access, particularly for patients for whom cost may be a barrier.”
Under the Pharmaceutical Benefits Scheme, the government agrees a single price with pharmaceutical companies to buy their medication, and provide it for a fixed co-payment of $25 for most patients.
Eli Lilly has applied to the scheme’s advisory committee four times for a funding deal to list the medication on the scheme.
Manny Simons, Eli Lilly’s general manager in Australia and New Zealand, said the price offered by the government was lower than other prices agreed globally, and included conditions the company found “unrealistic and unviable”.
“We do not make this decision lightly,” he said.
Strict funding caps on the deal would have exposed Eli Lilly to disproportionate financial risk, the company said.
The World Health Organisation last year included Mounjaro on its list of essential medications for Type 2 diabetes, and urged governments such as Australia to make GLP-1 receptor agonist drugs more affordable for people with obesity.
But Simons said Friday’s outcome could hamper efforts to have the medication listed for other conditions for which Mounjaro may be an effective treatment.
“Based on today’s outcome, it is difficult to see how a PBS listing for Mounjaro could be secured for Australians living with obesity or obesity-related disease,” he said.
More than 100 medications recommended for subsidies have not progressed to a PBS listing in the last five years, the company said in its statement.
In December, the PBAC recommended another weight loss drug, semaglutide (sold as Wegovy), be subsidised for patients with obesity and heart disease who have experienced a heart attack or stroke or who have symptomatic peripheral arterial disease.
Federal Health Minister Mark Butler was contacted for comment.
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