Effective obesity-management medication should be subsidised on the Pharmaceutical Benefits Scheme (PBS) to reduce health inequity, the Royal Australian College of GPs (RACGP) has said.
The change in the peak body for GPs' position on medication for weight loss, which could include semaglutide-based drugs, follows the RACGP's release of a new position statement on obesity prevention and management.
The position calls on the health and medical sector to reduce stigma and support patients to 'gain health' – rather than simply 'lose weight'.
RACGP Specific Interest Obesity Management Chair Dr Terri-Lynne South said while a PBS subsidy will help reduce obesity for some patients, the health system must support all patients to gain health, and maintain it.
"There is a growing body of evidence that semaglutide medicines are effective way for patients to reduce their risk of developing complex and chronic conditions that are linked to overweight and obesity," Dr South said.
"Around 32% of Australian adults live with obesity, and the National Obesity Strategy estimates the direct and indirect costs of this are around $12 billion per year. People who live with obesity also experience heart disease, diabetes, osteoarthritis, some cancers, and other chronic diseases at higher rates.
"Australia's high rate of obesity is also a major barrier to health equity.
"Patients in rural and lower socioeconomic status areas experience obesity at higher rates. Effective treatments can be prohibitively expensive – not just medication, but also healthy environments and health-improving lifestyle changes.
"Manufacturers have drawn exceptional profits from these medications. Now they must invest in reducing costs for patients. PBS spending is an investment in health, with competing calls for funding, so any spending must be efficient.
"If a medicine is effective and safe, and the cost of a condition to the health system outweighs the cost of treating it with a medicine, there's a strong case to subsidise that medicine.
"The evidence for semaglutide and similar GLP-1 receptor agonists as effective weight loss medicines is if not at, then approaching, that point.
"But semaglutide and similar medications can have side effects that make them unsuitable for many patients. The patients who benefit from them get the best results by also making lifestyle changes. Both groups of patients should be supported by their GP and care team to gain health, including by maintaining a healthy weight.
"Specialist GPs are well-placed to help our patients achieve and maintain health. PBS-subsidised medications could make a big, difference, but patients also need policy changes to help them to stay healthy.
"That means funding to spend the time they need with their specialist GP, and better access to health professionals like dieticians, especially via their general practice."
RACGP President Dr Michael Wright said all parties should commit to policies that double the funding available to practices to employ allied health professionals like dieticians in their teams, support access to healthy environments and food, and boost patients' Medicare rebates for longer consults by 40%.
"People with chronic illnesses get the best care when their specialist GP works with a multidisciplinary team," he said.
"Funding practices to employ the nurses and allied health professionals our patients need, like dieticians, pharmacists, psychologists, and diabetes educators, will immediately improve access to care for our patients. In the long term, it'll improve health and wellbeing, and mean fewer people end up in hospital.
"Better funding for longer consults will also immediately improve affordability and access to care. Patients receive less funding from Medicare for longer consults, yet these are essential to effectively and efficiently manage chronic illnesses.
"Continued investment in programs like the RACGP's Healthy Habits, which helps GPs support patients to set achievable physical activity, nutrition and sleep health goals, is also important.
"Too often people miss out on care that could have allowed for an earlier diagnosis or intervention. Weight loss is challenging and personal, so patients and GPs must work on solutions that work for them.
"We need a health system that support people to gain and maintain health. The best way to achieve that is with a specialist GP who knows you, your medical history, what you have tried and what you have found works for you."
In its plan for accessible and affordable general practice care, the RACGP has called on all parties to commit to:
- A 40% increase to all patients' Medicare rebates for GP consultations that last from 20-60 minutes, funding an extra 4.6 million bulk billed consults and halving out-of-pocket costs for patients who are not bulk billed
- Funding practices to employ more nurses and allied health professionals like dieticians by doubling the planned investment in the WIP – Practice Stream to $178 million a year, improving access to care.
