GLP-1s in Ireland: How weight-loss medications work under the HSE system
Weight-loss medications such as Ozempic , Wegovy and Mounjaro have become more widely-discussed and available in recent years. But which drugs are accessible, who can get them, and is there any potential for availability of the drugs increasing? What medications are available under the HSE system? Saxenda, which is injected daily, is the only form of GLP-1 therapy which is reimbursed for weight loss by the HSE . This means it is free under the medical card or subsidised for private patients on the Drugs Payment Scheme, which has a cost limit of €80 per month. The HSE has confirmed that more than 45,000 people are getting Ozempic for free under the Long-Term Illness Scheme, with another 8,348 receiving it under the medical card. However, it is only available under these schemes for the treatment of type 2 diabetes. It is not available under the Drugs Payment Scheme, although people can buy it privately for weight loss purposes, at a cost in excess of €200 a month. What is the HSE considering around Mounjaro? The HSE’s expert drugs group is to meet on Tuesday to discuss the potential reimbursement of the drug for weight loss purposes. A spokeswoman for the HSE said the process can take some time and that there may be a number of meetings of the Drugs Group before a recommendation is made to the HSE Senior Management Team. The spokeswoman added that discussions will be required with the Department of Health on the “potential overall impact on the health budget”. What is the difference between these medications? They are all known as GLP-1 medications, but often the active ingredient differs. Ozempic and Wegovy are both manufactured by pharmaceutical company Novo Nordisk. Meanwhile, Mounjaro, a once-weekly injection, is made by Eli Lilly. The active ingredient in Novo Nordisk’s jabs is a molecule called semaglutide, while Mounjaro uses tirzepatide. If they’re effective in treating obesity, why doesn’t the HSE just make them available? As is the case with decision-making for reimbursing all drugs under the public system, it comes down to cost-effectiveness. Before being made available through the public system, drugs are assessed by the National Centre for Pharmacoeconomics (NCPE) which looks at the evidence to support its efficacy, as well as the cost of the product and the impact it would have on those who take it. The NCPE assessment is used as a discussion point among the HSE drugs group, who then make recommendations to senior HSE management around reimbursement. Is Mounjaro believed to be cost-effective? In December 2025, the NCPE said the drug was not cost-effective but said the HSE should consider reimbursing it if it could agree with a price reduction with the manufacturer. Prof Michael Barry, who leads the NCPE, said earlier this year that the manufacturer Eli Lilly had made an offer for a significant price reduction that would make the drug cost-effective or close to it. However, he warned that even with this reduction, it could cost the State between €2 billion and €3 billion over five years. Ireland’s total drugs budget will top €4 billion next year. Will everyone be able to get it? There will be clinical criteria that must be met for a patient to be able to access the drug under HSE schemes. Clinicians will discuss this criteria with patients, with eligibility typically identified through a number of factors including BMI, obesity-related co-morbidities, lifestyle and diet. Do these drugs only help with obesity and diabetes? Some studies have indicated weight loss medications could be beneficial for other conditions, including lowering the risk of cardiovascular disease, slowing the progression of kidney disease and sleep apnoea, among others. Are there side effects to weight loss drugs? As with all medications, there is a risk of side effects. The Health Products Regulatory Authority said there have been over 1,500 reports of suspected adverse reaction from weight-loss medication since 2023.