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GLP-1 prescribing in Australia — access, cost & the Authority process
A GP reference for how PBS access, cost and the Authority process work for GLP-1 receptor agonists (semaglutide, dulaglutide, tirzepatide). It does not cover dosing, patient selection or side-effect management — those link out to the product information and clinical guidelines.
📋 Sources: PBS listing and indication status — healthdirect medicines and pbs.gov.au (Ozempic verified PBS-available 1 June 2026). Authority/Streamlined process — RACGP newsGP and PBS. MBS items 23/36/44, 965/967 — MBS Book July 2026 (mbsonline.gov.au). Dosing, contraindications — TGA Product Information. Supply — TGA Medicine Shortage Reports. Verified June 2026; PBS GLP-1 criteria change frequently — confirm current status before prescribing. This page is general reference information for health professionals, not clinical or prescribing advice, and does not replace the current PBS schedule, Product Information, or your clinical judgement.
Reference only — not prescribing or clinical advice. PBS listings, restrictions and supply status for GLP-1 medicines change frequently. The volatile specifics below are date-stamped and point to the live source. Last verified June 2026. Always confirm current PBS criteria and streamlined codes at pbs.gov.au, and dosing and contraindications in the current TGA Product Information, before prescribing.
The one rule that resolves most confusion: PBS subsidy follows the approved indication, not the molecule. GLP-1 agonists are subsidised for type 2 diabetes only. There is no PBS subsidy for weight management or obesity without a qualifying diabetes diagnosis — that is a private, full-cost prescription, regardless of brand.
PBS status at a glance
Indications and listings as published by the TGA and PBS. Confirm current status at pbs.gov.au — the weight-management products in particular have been changing.
Product (active)
TGA-approved for
PBS status
Patient cost route
Ozempic (semaglutide)
Type 2 diabetes
PBS-listed — T2DM only
PBS copay if criteria met; otherwise private
Trulicity (dulaglutide)
Type 2 diabetes
PBS-listed — T2DM only
PBS copay if criteria met
Mounjaro (tirzepatide)
Type 2 diabetes; chronic weight management; moderate–severe OSA in adults with obesity (BMI > 30) (TGA, Jun 2025)
Verify current PBS status at pbs.gov.au — not PBS-subsidised for OSA or weight at time of writing
Private for weight management and for OSA
Wegovy (semaglutide 2.4 mg)
Chronic weight management
Not PBS-listed. PBAC recommended a future listing (Nov 2025, established CVD + obesity group) — not yet in effect as of Jul 2026; verify at pbs.gov.au
Private (full cost)
Saxenda (liraglutide)
Chronic weight management
Not PBS-listed for weight management
Private (full cost)
Brands are illustrative of the AU market, not exhaustive, and indications/listings are confirmed live at the PBS. This table describes access and cost structure, not which agent to choose.
The Authority process (type 2 diabetes)
For the PBS T2DM indication, GLP-1 RAs are Authority required. A GP can initiate — no specialist referral is needed.
Initiation — Authority application made in real time via Online PBS Authorities (in your prescribing software / PRODA) or by phone.
Continuing — Authority required (Streamlined): a streamlined code on the script, no separate application.
The criteria centre on confirmed type 2 diabetes with inadequate glycaemic control despite an adequate trial of metformin (or where metformin is contraindicated or not tolerated), with the relevant detail documented in the Authority request. The exact current wording, the streamlined codes, and any CV-risk pathways are published at pbs.gov.au — confirm these there rather than relying on a summary, as they are revised periodically.
Documentation scaffold for the consult (copy to your notes)
A neutral template with blanks — complete it against the current PBS criteria for the specific product (pbs.gov.au). It does not assert clinical thresholds.
Cost: PBS vs private
PBS (T2DM, criteria met): standard co-payment — $25.00 general, $7.70 concession per script (PBS rates, March 2026; copay changes 1 January annually).
Private (weight management or off-indication) — approximate ranges
Full-cost private scripts vary by product, dose and pharmacy — and by dose tier within a product (patients titrate up over weeks/months, and each dose strength is a separately priced pack). As a rough guide (approximate, as of Jul 2026 — verify locally): semaglutide for weight management (Wegovy) is roughly $250–450/month across its dose range; tirzepatide (Mounjaro) is roughly $280–700/month, rising steeply from its starting dose to its maximum maintenance dose. These reflect online discount pharmacy pricing (near the cheaper end of the market) — traditional pharmacies and bundled telehealth programs commonly cost more. These are not fixed prices and shift with supply; quote the patient an indicative range and have them confirm with the pharmacy. See the patient-facing cost comparison for the full per-dose breakdown.
MBS items for the consult
There is no MBS item specific to GLP-1 prescribing — you bill the underlying service. Typically:
Standard consultation — time-tiered items 23 / 36 / 44 for the review.
Chronic disease management — where the patient has a GP Management Plan, items 965 (preparation) and 967 (review), each $160.60, support structured T2DM management. See the diabetes billing guide.
MBS items and fees verified against the MBS Book July 2026. Confirm current item descriptors at MBS Online.
Supply & compounded products
The 2022–2024 semaglutide shortage has largely resolved, but allocations and brand availability still move. Check live status at the TGA Medicine Shortage Reports database before assuming availability.
The TGA has acted to restrict compounded semaglutide and tirzepatide products. Confirm the current TGA position at tga.gov.au — only TGA-registered products are quality-assured.
Recent TGA safety updates (2025)
Three class- or product-level updates worth flagging at the consult. Source: tga.gov.au — check for the latest before relying on any summary.
Tirzepatide + oral hormonal contraceptives (TGA, Dec 2025). TGA could not rule out reduced contraceptive efficacy with tirzepatide (delayed gastric emptying). PI now advises: switch to a non-oral method, or add a barrier method, for 4 weeks after initiation AND for 4 weeks after each dose escalation. Counsel this at every initiation and titration visit for patients of reproductive potential. GLP-1 RAs are not recommended in pregnancy.
Class-level suicidal ideation warning (TGA, Sept 2025). PIs for the GLP-1 RA class have been harmonised: monitor for emergence/worsening of depression, suicidal thoughts/behaviour, or unusual mood changes. The ACM (June 2025) advised the available evidence did not support causal association — the update is about consistent class-level awareness, not a new contraindication. Weigh benefits and risks in patients with history of suicidal ideation.
Aspiration during GA / deep sedation (TGA, May 2025 update). Section 4.4 precaution added to all GLP-1 / dual GIP-GLP-1 RA PIs (dulaglutide, liraglutide, semaglutide, tirzepatide). Delayed gastric emptying is the underlying mechanism. Operationally this is the ANZCA April 2025 consensus territory — covered below.
Patient on a GLP-1 facing surgery or endoscopy?
A common question now reaching GPs. The Australian consensus changed — and not in the direction many expect.
The current Australian consensus does NOT recommend electively stopping GLP-1s before a procedure. Omitting a weekly agent for 1–2 weeks is unlikely to change gastric emptying, and stopping risks hyperglycaemia and loss of weight control. The periprocedural plan is built around diet and anaesthetist-side risk mitigation, not GP-led cessation.
What the April 2025 consensus (ANZCA, Australian Diabetes Society, GESA, NACOS) sets out:
Ask every patient about GLP-1 / GLP-1-GIP use before any anaesthesia or sedation, and flag it on the referral.
Don't electively cease — elective preprocedural cessation is not recommended.
Diet — a 24-hour clear fluid diet before the procedure, then standard 6-hour fasting, is recommended for all patients on these agents.
Symptoms are unreliable — absence of nausea/vomiting does not indicate an empty stomach.
The periprocedural decision sits with the anaesthetist / proceduralist — gastric ultrasound, IV erythromycin, deferral, or treating as a non-fasted patient are their calls, not the GP's.
If therapy was already interrupted (e.g. supply issue) for ≥4 elimination half-lives, the effect on gastric emptying can be assumed gone (see table).
Agent
Trade name
Schedule
Elimination half-life
Liraglutide
Victoza, Saxenda
Once daily
~12.6–14.3 hours
Dulaglutide
Trulicity
Once weekly
~4.7–5.5 days
Semaglutide
Ozempic, Wegovy
Once weekly
~5.7–6.7 days
Tirzepatide (GLP-1/GIP)
Mounjaro
Once weekly
~4.2–6.1 days
Half-lives per the ANZCA/ADS/GESA/NACOS consensus. The "4 half-lives" figure is for the scenario where therapy was already interrupted — it is not a recommendation to plan a cessation.