Trends in publicly subsidized and private access to GLP‐1 medicines indicated for type 2 diabetes in Australia, 2020–2025

AIMS: GLP-1 medicines provide substantial cardio-renal benefits for type 2 diabetes (T2D) and are increasingly used for weight loss. Most high-income countries subsidize access for T2D with restrictions; use outside of these restrictions occurs through private prescriptions. Despite strong consumer demand, the extent of private access to GLP-1 medicines remains poorly quantified. METHODS: We used national pharmaceutical sales data to quantify population use of GLP-1 medicines listed for T2D in Australia, May 2020-April 2025. We used Pharmaceutical Benefits Scheme (PBS) dispensing claims to measure subsidized access; we estimated private access as the difference between sales and PBS dispensings. We measured GLP-1 medicine use as number of units sold/dispensed and defined daily dose (DDD)/1000 population/day. RESULTS: Since May 2020, total sales of GLP-1 medicines indicated for T2D increased almost 10-fold. Most growth was in private access, driven by semaglutide and rapid uptake of tirzepatide. Supply dropped by 79% during periods of global shortage and primarily accessed through subsidized care. In the year May 2024-April 2025, the majority of GLP-1 medicines used were semaglutide (63.3%) and tirzepatide (30.7%). Half (47.8%) were accessed privately (26.9% of semaglutide; all tirzepatide). In this year, we estimate approximately 483 000-502 000 people accessed GLP-1 medicines each month, with 180 000-240 000 people accessing privately. CONCLUSIONS: Use of GLP-1 medicines indicated for T2D has increased dramatically, accessed by approximately half a million Australians each month, almost half of which is private. Our findings highlight demands outside of subsided care, equity concerns for access and pressures for health systems in meeting this demand.