Portugal Lowers Ozempic Co-Pays for Type-2 Diabetics with Obesity

The Portugal National Health Service (SNS) will now subsidise Ozempic, a decision that could slash monthly drug bills for thousands of people living with type-2 diabetes and obesity while adding a new line item to the State’s pharmaceutical budget.

Why This Matters

• Lower pharmacy co-pays: Patients previously paying the full €135 per pen can expect a 30–40% reimbursement.

• Widely applicable criteria: Any adult with BMI ≥ 30 or a high cardiovascular risk qualifies once standard therapies have failed.

• Potentially 400 000+ beneficiaries: Roughly 1 in 20 residents may eventually be eligible.

• Public spending watch: Diabetes drugs already cost the SNS €40 M in 2024; this move is forecast to push the total higher in 2026.

The Decision Behind the Subsidy

Portugal’s medicines regulator Infarmed approved funding after reviewing a public-financing dossier that showed semaglutide’s dual impact on glycaemic control and weight reduction. The green light arrived on 2 February, ending what patient groups called a “de facto discrimination” against diabetics who also struggle with obesity. Under the new rules, Ozempic becomes available as a second- or third-line therapy, prescribed in addition to diet, exercise and standard oral antidiabetics.

How Many People Could Benefit

Portugal is dealing with a double epidemic: about 900 000 adults carry a diabetes diagnosis, and 2 M live with obesity. Household surveys indicate that 22% of obese adults are also diabetic, yielding an estimated 440 000 potential candidates. Not all will meet the “insufficiently controlled” threshold, yet endocrinologists believe “a large majority” of current patients with a BMI over 30 will now be covered.

Financial Footprint for the State

The Ministry of Health allocated €15.3 B for 2026—up 6.3% on last year. Within that envelope, antidiabetic medicines are one of the fastest-growing lines, rising from €7.5 M in 2021 to €40 M in 2024 for semaglutide alone. Internal models projecting universal obesity coverage hinted at €2 B–€11 B over two years. While Ozempic’s niche indication costs far less, insiders at Direção-Geral da Saúde caution that “even a conservative rollout will stretch the drug budget.” The detailed fiscal impact remains sealed inside Infarmed’s technical report.

What This Means for Residents

Residents who fit the criteria can expect several concrete changes:

• Lower out-of-pocket expenses—current prices near €135 per injection pen could fall to roughly €80–€95 once the SNS share is deducted.

• Simpler paperwork: Family doctors in the SNS e-Receita system can issue an electronic prescription that automatically flags the reimbursement.

• Improved cardiovascular outlook: Studies cited by Infarmed show a 15% reduction in major cardiac events among high-risk users, potentially translating to fewer hospital stays.

• Tax implications: Co-pays remain deductible in the annual IRS health expenses declaration, stacking savings for eligible households.

The Road to Access

Clinical evaluation: Your primary-care physician verifies uncontrolled HbA1c despite first-line therapy and confirms a BMI ≥ 30 or documented cardiovascular risk.

e-Prescription: The doctor selects the new semaglutide code that triggers SNS coverage.

Pharmacy dispensing: Community pharmacists scan the prescription; the government portion is instantly settled, and the patient pays only the remainder.

Follow-up: After three months, continued reimbursement hinges on proof of either ≥ 1 kg weight loss or improved glycaemic metrics.

Expert Reactions

The Association for the Protection of Diabetics of Portugal (APDP) hailed the measure as “a long-overdue equaliser.” Pharmacoeconomist Helena Duarte notes that earlier access to weight-loss-adjunct medication “should cut downstream costs in amputations, dialysis and cardiovascular surgery.” However, she warns that “supply bottlenecks” could emerge if prescribers move faster than wholesalers can stock semaglutide.

Looking Ahead

Stakeholders expect the first reimbursement claims to surface in March. By year-end, the Ministry must decide whether to extend similar coverage to competing injectables such as Wegovy or Mounjaro. For now, residents dealing with both diabetes and obesity finally have a pathway to an effective—if still premium-priced—therapy without footing the entire bill themselves.