This fact sheet presents a study using Lumos data to explore patterns of initial semaglutide prescription by general practitioners in NSW not limited to subsidised PBS prescription.
Semaglutide (trading as Ozempic or Wegovy) was approved in 2019 by the Therapeutic Goods Administration (TGA) for adults with poorly controlled Type 2 Diabetes Mellitus (T2DM). In 2020, it was listed on the Pharmaceutical Benefit Scheme (PBS), facilitating subsidised access for eligible patients. It also has demonstrated efficacy for glycaemic control and for weight loss.
The monitoring of semaglutide use has been limited to subsidised PBS prescriptions for diabetes management, leaving uncertainty about patterns of private and off-label prescribing, particularly for non-diabetic indications such as obesity management.
Kuo, Hill et al.1 present a study using Lumos data to explore patterns of initial semaglutide prescription by general practitioners in NSW, not limited to subsidised PBS prescription. The study used data extracted for 5.6 million unique patients who had attended 680 general practices2. At the time, this comprised approximately 25% of NSW general practices.
There was a marked increase in initial semaglutide prescriptions between 2020 and 2023. Especially in:
The study analysed 59,009 first semaglutide prescriptions issued between 2020 and 2023.
Findings show a marked increase in initiation over time - especially among younger, female and non-diabetic patients.
There were also differences based on whether patients had diabetes or not - compared to those with diabetes, people without diabetes were more likely to be female and from socioeconomically advantaged areas. Non-diabetic females had lower Body Mass Index (BMI), while non-diabetic males had higher BMI.
These results indicate that a substantial proportion of prescribing occurs outside PBS criteria, highlighting growing off-label use and possible inequities in access.
In 2020, of the patients starting semaglutide, 8% were non-diabetic.
By 2023, the proportion of non-diabetic patients starting semaglutide was 34%.
Health policymakers, prescribers and regulators, tasked with ensuring equitable, evidence-based access to semaglutide and similar medications amid high public demand and constrained supply.
The Lumos program is the largest collaboration between NSW general practices, NSW Health and NSW Primary Health Networks (PHNs) to date.
Lumos links deidentified patient information from general practices and hospital services to understand how patients use health services in NSW. Lumos offers insights into population-level patterns and longitudinal continuity of care. This infrastructure allows for large-scale, representative analyses of real-world health data, enabling findings that reflect actual general practice patterns and patient diversity across NSW.
For more information on the steps between data collection and release of data for analytics, see Lumos Data Timelines Explained.
Lumos does not currently include Aboriginal Medical Services and the Aboriginality of patients cannot be identified in the data. Lumos is working with Aboriginal leaders and communities to implement Indigenous Data Sovereignty and Governance to address this gap.
Information contained in this publication is based on knowledge and understanding at the time of writing and is subject to change.