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Ozempic (Semaglutide)

PBS eligibility — type 2 diabetes · GLP-1 receptor agonist

Field: Endocrine & DiabetesCode: DE-01Updated: June 2026Reference: pbs.gov.au
PBS-listed for type 2 diabetes as add-on therapy; favoured with established CVD or CKD. Initiation gate: contraindication/intolerance to an SGLT2 inhibitor, or no clinically meaningful glycaemic response to one. Verify current criteria at pbs.gov.au.

1Eligibility — who qualifies on the PBS

✓
Diagnosis — Type 2 diabetes mellitus, not type 1, LADA, MODY or gestational diabetes.
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SGLT2i criterion — Contraindication/intolerance requiring discontinuation of an SGLT2 inhibitor, or no clinically meaningful glycaemic response to one. This is the current initiation gate (PBAC, June 2024).
✓
Combination — Used with at least one of metformin, a sulfonylurea or insulin — see the combinations table below.
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Authority — Initiation: Authority Required (phone 1800 888 333 or PBS Online/HPOS). Continuation: Streamlined, no phone call.

2Which combinations are PBS-subsidised

Combination withSubsidised?Notes
+ MetforminYesDual therapy.
+ SulfonylureaYesDual therapy.
+ Metformin + SUYesTriple therapy.
+ InsulinYesDual or triple therapy, with or without metformin.
+ SGLT2i / DPP-4iNoNot co-subsidised for diabetes. SGLT2i exception: prescribed for HF/CKD with no glycaemic response. Never with another GLP-1 RA.

3Practical prescribing

  • Not available on 60-day prescriptions (GLP-1 RAs and insulins are excluded) — 30-day quantities only. The 1.5mL pen was discontinued; the 3mL pen is the current presentation (same dose delivered).
  • Patients already established on a GLP-1 RA for T2DM do not need to requalify under the 2024 rules.
  • Ozempic is the T2DM stream; Wegovy (obesity/CV-risk) is a separate, locked indication — patients cannot switch streams to bypass criteria. Confirm strengths, pack sizes and repeats at pbs.gov.au.

Safety

  • Not for type 1 diabetes, LADA or DKA.
  • MEN2 / medullary thyroid cancer (personal or family history).
  • Acute pancreatitis — withhold; specialist review before any restart.
  • Cease ≥2 months before a planned pregnancy.

Check / exclude

  • Confirm and document the SGLT2i criterion before initiating.
  • Not with a DPP-4i, another GLP-1 RA or an SGLT2i for diabetes.
  • Hypoglycaemia risk rises with insulin or a sulfonylurea.
  • Re-verify the current PBS restriction at pbs.gov.au.

DE-01 v1.0 · Reviewed Jun 2026 · Review Dec 2026

For health-professional use. Summary only — not a substitute for the current PBS Schedule or the approved product information.