The data comes from a preliminary study conducted by the National Authority for Medicines and Health Products (Infarmed) at the request of the Ministry of Health to analyse the financial impact of reimbursing these medications.

On the day the National Program for the Prevention and Management of Obesity (PNPGO) was published, Ana Povo, the Secretary of State for Health, told the Lusa news agency that this plan had been under development since the beginning of the year and that, at the time, co-payment for some of these medications was being considered.

“Therefore, we asked the responsible entity, Infarmed, to conduct a preliminary study on the financial impact of implementing this measure, to see what the gains would be for the public health of the population,” said Ana Povo.

The preliminary results revealed that if a 90% co-payment for all currently available medications were implemented, the State would spend two billion euros.

This would be a “burden on the State greater than all current outpatient medication expenditure,” considering the more than 1.6 million people with obesity in Portugal (about 16% of the population), she told Lusa.

In 2024, the National Health Service spent €1,683.8 million on co-payments for medications that users buy in pharmacies, according to the latest Infarmed report.

Currently, there are five medications available on the Portuguese market for the treatment of obesity, all requiring a prescription and not covered by the National Health Service (SNS): Mounjaro (Tirzepatide), Wegovy (Semaglutide), Saxenda (Liraglutide), Mysimba (Bupropion + Naltrexone), and Orlistat 120 mg.

Ana Povo emphasised that, “even restricting the coverage of these medications to a population with obesity grades II and III, the expenditure would exceed 600 million euros per year,” a value approximately four times higher than “all current spending on cerebrovascular diseases in Portugal, which is around 115 million euros.”

“This obliges us to guarantee a response to these people, who cannot be left behind, but also to work on a sustainability model so as not to jeopardize the entire health system,” she stressed.

More studies

The Ministry of Health is now awaiting “more detailed studies from Infarmed,” said the minister, adding that the hypothesis under analysis is to follow other European countries and subsidise only some medications.

“Not all, but some. That is what we are working on now with Infarmed,” she stressed.

The Ministry of Health emphasizes that no European country currently subsidizes all of these medications.

In Portugal, obesity affects 28.7% of adults and being overweight affects 67.6%.

In 2022, childhood obesity affected 13.5% of children aged six to eight, and overweight affected 31.9%.

Currently, overweight accounts for 7.5% of mortality in Portugal and is the second leading risk factor contributing to the burden of disease in the country.

The Organisation for Economic Co-operation and Development (OECD) estimates that 10% of total health expenditure in Portugal is allocated to the treatment of diseases related to overweight, with an overall impact of 3% on the gross domestic product.