Portugal Weighs Subsidising Weight-Loss Injections for Patients with Obesity

People in Portugal could soon find the cost of slimming treatments falling almost as quickly as their waistlines. The national medicines regulator, Infarmed, is assessing whether the state should co-pay powerful weight-loss drugs that until now have been reserved—financially and legally—for diabetes care.

If the green light arrives, thousands battling obesity would gain access to therapies that international studies credit with double-digit body-mass reductions. But every kilo subsidised will show up in the public accounts, forcing Lisbon to balance immediate spending against future savings on cancer, heart disease and type 2 diabetes.

Snapshot: what is driving the debate

• Portugal’s adult population shows one of Europe’s highest obesity rates, with roughly 17 % classified as obese and 50 % overweight.

• The World Health Organization recently urged wider access to GLP-1 analogue therapies for severe obesity, framing the disease as chronic rather than lifestyle-driven.

• Infarmed is exploring a scenario in which the SNS (National Health Service) would co-finance prescriptions only for the most serious clinical cases.

• Early modelling suggests annual expenditure could add €600 M if eligibility is broad, yet potentially save billions long-term through avoided complications.

• Persistent drug shortages—already hitting Ozempic and Trulicity—raise questions about whether supply can keep pace with subsidised demand.

The medicines under scrutiny

At the heart of the conversation are next-generation injectables such as semaglutide, tirzepatide and liraglutide. Marketed under brand names like Ozempic, Wegovy, Mounjaro, Saxenda and Trulicity, these GLP-1 receptor agonists mimic intestinal hormones that regulate appetite and blood sugar. Most Portuguese pharmacies stock them chiefly for diabetes, where they already enjoy state reimbursement. Shifting the same molecules into an obesity indication would require Infarmed to define new dosing rules, treatment windows and adherence monitoring, all while negotiating hefty price reductions with manufacturers.

Price tag versus prevention

Health-economy analysts inside the Ministry of Finance warn that a broad subsidy could eclipse the entire outpatient medicines bill of recent years. Yet endocrinologists counter that every avoided heart attack, cancer diagnosis or dialysis session trims future costs. A preliminary Infarmed dossier estimates that covering only BMI ≥ 35 cases might break even within 7 years via lower hospitalisations and sick-leave payouts. Anything wider would need parallel reforms, such as buying generics once patents expire and using centralised procurement to secure discounts.

Chronic shortages muddy the waters

Pharmacists across Lisbon, Porto and Faro report that weekly allocations of GLP-1 vials sell out in hours. Manufacturers point to global demand surges and limited filling lines. Infarmed has cautioned that supply tensions are likely to persist throughout next year. Subsidising a product that cannot be reliably stocked risks fuelling parallel markets and undermining trust in the SNS.

Clinicians and patient groups turn up the volume

The Society for Endocrinology and Metabolism, alongside the patient-led ADEXO association, argue that co-payment is a matter of equity: obesity hits hardest in lower-income districts where private prescriptions are unaffordable. "We treat bariatric surgery for free but ask patients to pay 100 % for medicines that might prevent surgery," notes Paula Freitas, an endocrinologist at São João Hospital. On the other side of the ledger, junior doctors’ unions worry that an expensive new benefit could crowd out primary-care hiring unless fresh funding is found.

Learning from neighbours

Spain reimburses semaglutide only for diabetes, while Denmark and Germany have started partial subsidies for severe obesity, capping annual doses per patient. Norway ties coverage to mandatory lifestyle-change programmes, penalising non-adherence. These examples hint that Portugal may adopt a tiered model: higher state help for the gravest cases, rising patient co-pays as BMI drops, and obligatory dietetic counselling.

Timeline: what comes next

Infarmed expects to finish its cost-effectiveness report before year-end. Should the verdict be favourable, the Ministry of Health would still need to draft a decree defining eligibility, pharmacy dispensing protocols and budget ceilings—a process that could stretch into the first half of next year. Meanwhile, dieticians urge citizens not to shortcut weight loss by ordering replicas online. "Whatever Infarmed decides, we will still need nutritional education, urban planning that promotes exercise and taxation on ultra-processed foods," says public-health researcher Inês Madeira.

In short, Portugal is edging toward a policy crossroads: either it bankrolls a modern pharmacological tool against a rising epidemic or it doubles down on traditional, less costly measures whose limitations are increasingly clear. The final decision will reveal how much value the country places on preventive spending—and how creative policymakers can be in financing it.