Semaglutide1mg weeklyRestricted for weight lossPBS: diabetes

Ozempic off-label restrictions explained

Since October 2024, new off-label prescriptions of Ozempic for weight loss have been restricted in Australia. Here's what changed, why, and what your options are.

What happened?

Ozempic (semaglutide 1mg) is TGA-approved for type 2 diabetes management. However, because it contains the same weight-loss-promoting ingredient as Wegovy (at a lower dose and lower cost), it was widely prescribed "off-label" for weight loss.

This off-label demand created significant supply shortages, leaving many diabetes patients unable to access their medication. In response, the Australian government introduced restrictions on new off-label prescriptions for weight loss.

What does this mean for you?

  • New patients: You generally cannot get a new Ozempic prescription for weight loss
  • Existing patients: If you were already prescribed Ozempic off-label, you may be able to continue — discuss with your doctor
  • Diabetes patients: Ozempic remains fully available for its approved indication

Your alternatives for weight loss

Will the restriction be lifted?

There is no indication the restriction will be removed. The government views it as necessary to protect the diabetes medication supply. As Wegovy becomes more widely available (and potentially PBS-listed), the need for off-label Ozempic prescriptions should decrease.

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The timeline of events

  • 2017: Ozempic launched for type 2 diabetes
  • 2020–2022: Off-label weight loss prescribing explodes globally, fuelled by social media and celebrity use
  • 2022–2023: Severe shortages in Australia — diabetes patients unable to access their medication
  • August 2024: Wegovy (semaglutide 2.4mg) approved by TGA for weight loss — the "proper" weight loss version
  • October 2024: Government restricts new off-label Ozempic prescriptions for weight loss
  • October 2024: Compounded GLP-1 medications also banned

Was the restriction fair?

From a public health perspective, yes. Diabetes patients were being denied access to a medication they needed for blood sugar management because of massive off-label demand for a purpose it wasn't approved for. With Wegovy now available as the approved weight loss version, the off-label use case is less justifiable.

From an individual patient perspective, the restriction was frustrating — especially for those who were already benefiting from off-label Ozempic and had to switch to a more expensive alternative. The real solution is PBS subsidisation of Wegovy, which would make the approved weight loss option affordable.

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