Australia GLP-1 access trends, 2020-2025

An Australian medicines-use study estimated that total sales of GLP-1 medicines indicated for type 2 diabetes rose almost tenfold from May 2020 to April 2025. In the final year, 47.8% of use was accessed privately rather than through subsidized Pharmaceutical Benefits Scheme dispensing^[1]. The figures describe distribution and payment routes. They do not reveal each patient's diagnosis, treatment outcome, or reason for receiving a private prescription.

The growth was led by semaglutide and rapid uptake of tirzepatide. Researchers estimated that 483,000 to 502,000 people accessed medicines in this group each month from May 2024 through April 2025, including 180,000 to 240,000 through private access. Those ranges come from population-level sales and dispensing data rather than a registry of identifiable patients.

How the researchers estimated access

The analysis used national pharmaceutical sales data for GLP-1 medicines listed for type 2 diabetes in Australia. Publicly subsidized access was measured from Pharmaceutical Benefits Scheme dispensing claims. Private access was estimated as the difference between total sales and PBS dispensings^[2]. Use was reported both as units and as defined daily doses per 1,000 people per day.

This subtraction method captures medicine moving outside the subsidized route, but it cannot supply the clinical detail found in patient records. A private unit could have been prescribed for a use that met or did not meet a subsidy restriction. The data do not show why a person paid privately, whether a prescription was for diabetes or weight management, or whether the medicine was taken as supplied.

What changed between 2020 and 2025

Total sales increased almost tenfold across the five-year window. The abstract says most growth occurred in private access. That pattern indicates demand outside PBS-subsidized dispensing, but it should not be read as a direct count of off-label use. Subsidy eligibility, product availability, indication, patient preference and willingness to pay can all affect the route through which a prescription is filled.

Supply disruption interrupted the upward trend. During periods of global shortage, supply dropped by 79%, and the remaining medicine was accessed mainly through subsidized care. The aggregate result shows how sharply shortages changed distribution. It does not identify which patients lost access, whether they switched products, or what happened to their health during the disruption.

Semaglutide and tirzepatide dominated recent use

From May 2024 through April 2025, semaglutide accounted for 63.3% of medicine use in the study and tirzepatide accounted for 30.7%^[1]. Together, those products represented most of the observed market. The paper reports that 26.9% of semaglutide use was private, while all tirzepatide use in that period was private under the access categories analyzed.

All-private access for tirzepatide describes the Australian subsidy setting during this study period. It does not mean the medicine lacked regulatory authorization, and it does not show that every prescription was written for weight loss. Regulatory approval, public subsidy and an individual prescription answer different questions. The study measured the last of these only through aggregated distribution routes, not through clinical notes.

What the monthly estimates mean

The authors estimated that roughly half a million Australians accessed these medicines per month in the final year. Of those, 180,000 to 240,000 were estimated to use private access^[2]. The range reflects the conversion of sales and dispensing volumes into estimated people. It should not be treated as an exact monthly patient census.

Defined daily doses also require care. A defined daily dose is a standardized drug-utilization unit used for population comparisons. It may differ from a person's prescribed dose and does not describe adherence. Changes in pack size, titration patterns, wastage, stock on hand, or refill timing can separate units sold from people actively using treatment on a given day.

Why the public-private split matters

The split raises an access question because private payment can make availability depend more heavily on personal finances. The authors highlight equity concerns and pressure on health systems trying to meet demand. Their data document the scale of private purchasing, but they do not measure household income, out-of-pocket cost, unmet need, regional availability, or differences in outcomes between public and private patients.

A large private share also does not establish inappropriate use. Australia applies restrictions to subsidized access, and people can receive lawful private prescriptions outside those reimbursement rules. Evaluating appropriateness would require information about diagnosis, clinical history, contraindications and treatment goals. None of those variables can be reconstructed from national sales minus PBS dispensing.

What the study does not say about treatment

This was a drug-utilization analysis, not a trial of effectiveness or safety. It cannot compare weight loss, glucose control, cardiovascular outcomes, or adverse effects between products. Readers looking for product-specific clinical context can use the semaglutide evidence guide and the tirzepatide evidence guide. The Australian access estimates should not be used to choose between them.

Nothing in the report supports buying medicine outside regulated prescribing and dispensing channels. It offers no dose guidance and no basis for starting, stopping, or switching treatment. Product choice and access can depend on diagnosis, eligibility, availability and personal risk. A qualified healthcare professional can address those factors using current Australian prescribing and subsidy information.

What we do not yet know

The abstract does not break private access down by indication, age, sex, income, state, or rurality. It cannot show how many people sought treatment but could not obtain it. We also do not know from these data whether patients stayed on therapy, switched during shortages, or experienced gaps that affected clinical outcomes.

The study window ended in April 2025. Later subsidy decisions, supply changes or new products could alter the mix quickly. Sales-based estimates may also diverge from actual administration. Future work linking dispensing with clinical and demographic data could test the equity concerns more directly, provided privacy protections are maintained.

Private access drove much of the growth

National sales and PBS claims point to a rapid expansion of GLP-1 medicine use in Australia, with nearly half of estimated use outside subsidized dispensing by the final year. The strongest conclusion concerns access routes and market scale. The study does not identify individual indications or outcomes, so it cannot tell readers whether a private prescription was clinically suitable or whether one medicine was better than another.

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