Portugal is to introduce a 15% subsidy for prescription obesity medicines from February next year — but family doctors warn that restrictive eligibility rules will leave many patients unable to benefit.
Under regulations published today, the subsidy will be available only to patients enrolled in a dedicated hospital obesity programme, with prescriptions issued by designated specialists.
Family doctors will be excluded from prescribing the medicines under the scheme – despite routinely treating conditions associated with obesity, including diabetes and high blood pressure.
Nuno Jacinto, president of the Portuguese Association of General and Family Medicine (APMGF), told Lusa the government is creating “a huge barrier to access”.
Several local health units lack endocrinologists or have very limited access to them, he said. Internal medicine appointments are also difficult to obtain.
“Telling people they can only access the subsidy through these consultations is the same as telling many patients they will not have access to subsidised obesity medication,” he stressed.
The rules require patients to be followed by the non-surgical hospital care unit of their local multidisciplinary obesity team. Their treatment must include physical activity planning and nutritional and psychological support.
Patients must also have an active clinical record under the SNS’s integrated obesity care pathway, introduced last year as part of the National Programme for the Prevention and Management of Obesity.
Only endocrinologists, internal medicine specialists or paediatricians belonging to the hospital team will be authorised to prescribe medicines eligible for the subsidy.
The government says the scheme aims to ensure equitable and sustainable access to treatment within the SNS national health service. The State contribution will cover 15% of the price, leaving patients to meet the remaining 85%.
Jacinto warned that excluding primary care will force family doctors to refer thousands of patients to hospital services, clogging consultations (even more than they are clogged already).
He questioned why GPs were considered competent to manage diabetes, cholesterol disorders and hypertension, but excluded from prescribing subsidised obesity treatment.
In his view, the restrictions reflect a funding problem that the government should simply admit to.
“There is no money to subsidise medication for everyone with obesity, and that needs to be stated clearly,” he challenged.
Source material: LUSA
Natasha Donn
Journalist for the Portugal Resident.