Eli Lilly Abandons PBS Negotiations for Mounjaro, Leaving 450,000 Australians Without Subsidized Access
核心洞察
Pharmaceutical giant Eli Lilly has walked away from negotiations with the Australian government to list Mounjaro (tirzepatide) on the Pharmaceutical Benefits Scheme, citing unviable pricing and unrealistic conditions.
An estimated 450,000 Australians with Type 2 diabetes (搜索) will continue paying hundreds of dollars monthly out-of-pocket for the weekly injectable medication that was recommended for PBS subsidization.
The company stated that strict funding caps would expose Eli Lilly to disproportionate financial risk, and the government's price offer was lower than globally agreed prices.
Pharmaceutical giant Eli Lilly has abandoned negotiations with the Australian government over subsidizing its diabetes and weight loss drug Mounjaro, leaving an estimated 450,000 Australians to continue paying hundreds of dollars monthly for the medication. The company cited unviable pricing conditions and disproportionate financial risk as reasons for walking away from the Pharmaceutical Benefits Scheme (PBS) listing discussions.
PBAC Recommendation Rejected Despite Clinical Need
The Pharmaceutical Benefits Advisory Committee (PBAC) recommended on Friday that tirzepatide, marketed as Mounjaro, be subsidized for adult patients with inadequately controlled Type 2 diabetes (搜索). The committee acknowledged "the clinical need for additional effective treatment options for people with type 2 diabetes mellitus, noting that a proportion of patients do not achieve adequate glycaemic control with currently PBS-listed therapies."
The PBAC also noted that "tirzepatide is currently available through the private market and considered that PBS listing would improve equity of access, particularly for patients for whom cost may be a barrier."
Pricing Dispute Leads to Breakdown
Manny Simons, Eli Lilly's general manager in Australia and New Zealand, explained that the price offered by the government was lower than other prices agreed globally and included conditions the company found "unrealistic and unviable." Under the PBS, the government negotiates a single price with pharmaceutical companies to provide medications for a fixed co-payment of $25 for most patients.
"We do not make this decision lightly," Simons stated, emphasizing that strict funding caps on the deal would have exposed Eli Lilly to disproportionate financial risk.
This marks the fourth time Eli Lilly has applied to the PBS advisory committee for a funding deal to list the medication on the scheme.
Global Recognition and Future Implications
The World Health Organisation included Mounjaro on its list of essential medications for Type 2 diabetes (搜索) last year and urged governments such as Australia to make GLP-1 receptor (搜索) agonist drugs more affordable for people with obesity (搜索).
Simons warned that Friday's outcome could impact future applications for other conditions. "Based on today's outcome, it is difficult to see how a PBS listing for Mounjaro could be secured for Australians living with obesity (搜索) or obesity-related disease," he said.
While the door appears shut on a PBS deal for Type 2 diabetes (搜索), Simons indicated the company remains open to negotiating with the government on solutions outside the traditional scheme.
Broader Context of PBS Challenges
The company noted that more than 100 medications recommended for subsidies have not progressed to a PBS listing in the last five years. The PBS system has also created international tensions, with the Trump administration arguing that the single buyer model "significantly undervalues American innovation through unfair drug pricing practices."
In December, the PBAC recommended another weight loss drug, semaglutide (sold as Wegovy), be subsidized for patients with obesity (搜索) and heart disease who have experienced a heart attack or stroke or who have symptomatic peripheral arterial disease.
Federal Health Minister Mark Butler declined to comment on the Mounjaro decision.