Will my Ozempic or Mounjaro PBS access change after the PBAC review?

Nothing changes until the PBAC meets in November 2026 and any decision is implemented — typically several months after a PBAC meeting. The review is about prescribing restrictions for type 2 diabetes specifically, not about removing GLP-1 medicines from the PBS. If you are currently on a GLP-1 medicine under the PBS for type 2 diabetes, your access continues while the current rules are in place. Your GP can update you on the outcome after the November meeting.

What is the difference between streamlined authority and telephone authority for PBS prescriptions?

Under streamlined authority, GPs can prescribe by ticking the relevant box on the prescription — no further approval needed. Under telephone or electronic authority, the GP must contact Medicare Australia to get an approval code before writing the script. The RACGP estimates this adds significant time per prescription, multiplied across thousands of scripts per year. For GLP-1 continuation prescriptions specifically, the RACGP argues the clinical criteria are already met and the extra approval step adds cost without adding safety.

RACGP asks PBAC to keep Ozempic prescribing simple for GPs

The RACGP has submitted to the Pharmaceutical Benefits Advisory Committee ahead of a November 2026 review of GLP-1 medicine PBS restrictions, urging the PBAC to preserve streamlined authority for continuation prescriptions. The submission argues that returning to telephone or electronic authority requirements would add significant administrative burden to both GPs and patients without improving clinical outcomes.

GLP-1 medicines — which include semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro), and oral semaglutide (Rybelsus) — are currently PBS-listed for type 2 diabetes under specific restriction criteria. Continuation prescriptions use “authority required (streamlined)” — a lower-admin pathway. Initiation prescriptions require telephone or electronic authority.

The November review will assess whether restriction changes introduced in June 2024 worked as intended.

If you are currently on one of these medicines for type 2 diabetes, or your GP has raised them as an option, the outcome of this review matters to the practical experience of obtaining your prescription. Nothing changes until after November — but the RACGP’s advocacy for the streamlined pathway is worth understanding.

Background: what changed in June 2024, and why

In June 2024, the PBS restrictions on GLP-1 medicines were updated to clarify that these agents are subsidised only when used in combination with metformin, a sulfonylurea, or insulin — not in combination with DPP-4 inhibitors or SGLT-2 inhibitors. The change followed a utilisation analysis showing prescribing was occurring outside PBS restrictions.

The PBS review page outlines the clinical rationale: GLP-1 medicines have established benefit alongside metformin and other first-line agents, but prescribing alongside DPP-4 inhibitors or SGLT-2 inhibitors was occurring in combinations where the evidence base is less clear.

The PBAC’s November review will assess whether those 2024 changes achieved the intended outcome — limiting GLP-1 prescribing to the appropriate population — and whether the current restriction settings remain fit for purpose.

What the RACGP is arguing

The RACGP’s core argument is about the difference between authority types and their practical impact.

The college’s submission states directly: “Authority arrangements that require additional telephone or online approval processes impose significant time costs on general practitioners and patients, reducing time available for clinical care.”

The argument is not that the restriction criteria themselves are wrong. It is that the mechanism for applying them — telephone or electronic authority for initiation, streamlined for continuation — creates an asymmetry that punishes ongoing access while theoretically protecting initiation. And that asymmetry carries real-world cost in a general practice environment already operating under time pressure.

Dr Gary Deed, chair of the RACGP’s diabetes specific interest group, offered a more nuanced framing to Medical Republic: the telephone authority process at initiation has practical value — it is what identified the unintended prescribing combinations in the first place. The data that drove the June 2024 restrictions came partly from that monitoring mechanism. Removing it entirely risks losing that visibility.

His framing is worth holding: “It’s about equity and importance of access because there’s a lot of emerging medications coming, and the pool of money isn’t exponential.” GLP-1 medicines are expensive. The PBS is finite. The PBAC has to weigh prescribing access against cost-effectiveness across a landscape where newer agents are continuously arriving.

The both-and

The RACGP’s position is understandable from a general practice perspective: telephone authority takes time, and time in general practice is scarce. Reducing administrative friction for continuation prescriptions — where the clinical decision has already been made — has a straightforward argument in its favour.

The PBAC’s mandate is more complex. It is not just assessing clinical appropriateness for individual patients; it is managing the overall cost and appropriateness of prescribing across the population. The June 2024 restrictions existed because prescribing was occurring outside intended criteria. The November review will determine whether those restrictions worked — and if they did, whether relaxing the oversight mechanism now would allow the same drift to recur.

For patients, the both-and is: accessible prescribing pathways reduce barriers to evidence-based treatment for a condition (type 2 diabetes) that carries significant downstream cardiovascular and renal burden. And adequate oversight of expensive medicines ensures the PBS can continue to fund the full range of treatments Australians need, including the next generation of agents that are still in the pipeline.

Neither position is wrong. The policy question is which risk matters more in this particular moment.

What this means this week

If you are currently on a GLP-1 medicine for type 2 diabetes, nothing changes this week. The current streamlined authority for continuation prescriptions remains in place until after the November PBAC meeting, and any implementation of changes typically follows months after a PBAC decision.

If you are considering starting a GLP-1 medicine, the current initiation pathway (telephone authority) remains unchanged for now. Your GP can work through whether you meet the PBS criteria for a type 2 diabetes indication.

If your GLP-1 was prescribed outside a formal type 2 diabetes indication — for weight management specifically, rather than as part of diabetes management — this review is about a different prescribing pathway. The weight management PBS listing for GLP-1 agents uses separate criteria and is not directly affected by this review.

For GPs, the RACGP submission is a useful read regardless of the PBAC outcome — it lays out the current prescribing criteria clearly and frames the administrative burden argument in terms that translate directly to consultation time.

The November review will land before the end of the year. The RACGP’s advocacy is noted. The outcome depends on how the PBAC reads the utilisation data from the past two years.

Verdict: maybe — if you are on GLP-1 medicines for type 2 diabetes, this review may affect how your prescription is processed next year; watch for the November PBAC outcome.