Overseas-registered Ozempic is available While the Australian-registered Ozempic is subsidised on the Pharmaceutical Benefits Scheme (PBS), the overseas-registered products currently are not.
This treatment will now be available to the approximately 40,000 individuals who accessed a comparable treatment for this chronic disease through the PBS in 2022. Patients would have to pay more than $1,700 for each Ozempic course without the subsidy. Now, each script will cost $41 or $6.60 if using a concession card.
The TGA continues to advise people to source Ozempic only from Australian pharmacies with a valid prescription.
Possibly, if a doctor recommends it. Currently, Ozempic is only approved for use in people with type 2 diabetes. However, doctors may prescribe Ozempic off-label for weight loss.
Get a prescription from your HCP: The first step is to get a prescription from your HCP. They will provide you with a prescription that you can take to your local pharmacy. Purchase from a local pharmacy: Once you have your prescription, you can purchase Ozempic® from your local pharmacy.
Some Medicaid plans cover medications like Ozempic and other GLP-1 drugs. To see if Ozempic is covered by your Medicaid plan, visit the website for your state's Medicaid program. You must meet certain eligibility requirements to be covered by Medicaid, such as being low-income.
Although patients spend less on food while taking it, in 2022 (when it was more easily available in Australia) it cost around $130 a month. It could be pricier once supply issues are fixed, because the manufacturer Novo Nordisk is spending millions of dollars building new facilities to meet the increased demand.
It's one of the prescription drugs on which Medicare, the federal health care program for people age 65 and older and for younger people with certain disabilities, spends the most money each year. But Medicare doesn't cover Ozempic for weight loss — only for diabetes.
Ozempic is only intended and approved for people with type 2 diabetes. You should not take it solely for weight loss. Doing so may prevent patients who require the medication for blood sugar management from getting it.
Saxenda is an approved weight loss medication, and is readily available in Australia. Cost is approximately $387 a month. The knock on effect from the Ozempic shortage, is that Trulicity which is manufactured by Ely-Lilly is now in short supply.
If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1-, 2-, or 3-month prescription (maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription).
Wegovy is an injectable weight loss medication that is being prescribed by Australian health professionals and doctors. Such is the popularity that the main component - Semaglutide - ran out of stock in pharmacies in Australia and worldwide in early 2023.
Overseas-registered Ozempic is available
While the Australian-registered Ozempic is subsidised on the Pharmaceutical Benefits Scheme (PBS), the overseas-registered products currently are not.
The nation's medicines watchdog has approved a new drug Saxenda, a natural gut hormone, that sends a signal to the brain to say food has arrived in the stomach and reduce appetite.
So, on average, with the recommended starting Ozempic dose of 0.25 mg, a 500 to 1000 calorie reduced diet, and exercise 3 times a week, you can expect to lose 3-5 pounds in the first month of treatment, which works out to about 3% of body weight for most overweight or obese individuals.
"And the costs can be anywhere between $1,000 to $1,500 a month." Both Ozempic and Mounjaro are approved by the U.S. Food and Drug Administration to treat Type 2 diabetes, but some doctors prescribe them "off-label" for weight loss.
Is Ozempic available for those without diabetes? Ozempic is only approved by the FDA for the treatment of type 2 diabetes. People who don't have diabetes may be able to take Ozempic “off-label” with a prescription from their doctor. “Off-label” means for use other than what is approved by the FDA.
Metformin
Metformin is a widely used first-line medication for treating type 2 diabetes and can also be considered a lower-cost alternative to semaglutide (Ozempic).
In one particular trial, conducted over 2 years, using 1mg of Ozempic with lifestyle interventions — such as diet changes and exercise — was compared with patients who only had lifestyle interventions [7]. Patients lost an average of 4.9kg with Ozempic compared to losing only 0.5kg without the drug.
Research has proven that higher doses of Ozempic — 2.4 milligrams of semaglutide — are very effective for reducing weight in people with obesity. In one landmark study, people with obesity who used the drug in combination with lifestyle interventions lost about 15% percent of their body weight in 68 weeks.
Medicare covers Ozempic for Type 2 diabetes
Because it's an outpatient prescription drug, Ozempic falls under Medicare Part D. Original Medicare (Part A and/or Part B) won't cover it.
Ozempic® (Semaglutide) has not been approved for reimbursement for any other indication. Reimbursement support for Ozempic® (Semaglutide) for the treatment of diabetes only is available to those with eligibility under the General Medical Services (GMS) Scheme or the Long-Term Illness (LTI) Scheme.
Following the DA communication, health professionals have now been asked to prescribe and dispense Ozempic for only those adults living with type 2 diabetes.