Eli Lilly Declines Government Subsidy for Diabetes Drug Mounjaro, Affecting 450,000 Australians

Apr 24, 2026, 07:46

Introduction

Approximately 450,000 Australian patients with Type 2 diabetes will not receive subsidized access to the weight loss medication Mounjaro, following a decision by pharmaceutical company Eli Lilly to reject a recommendation for government funding.

Main Body

The Pharmaceutical Benefits Advisory Committee (PBAC) recommended on Friday that tirzepatide, a once-weekly injectable medication marketed as Mounjaro, be listed on the Pharmaceutical Benefits Scheme (PBS) for adult patients with inadequately controlled Type 2 diabetes. The PBAC acknowledged a clinical need for additional effective treatment options, noting that some patients do not achieve adequate glycemic control with currently subsidized therapies. The committee also observed that tirzepatide is currently available through the private market and concluded that PBS listing would improve equity of access, particularly for patients for whom cost is a barrier. Under the PBS, the government negotiates a single price with pharmaceutical companies and provides the medication for a fixed co-payment of A$25 for most patients. Eli Lilly had applied to the PBAC four times for a funding arrangement. Manny Simons, Eli Lilly’s general manager for Australia and New Zealand, stated that the government’s offered price was lower than prices agreed in other countries and included conditions the company deemed “unrealistic and unviable.” The company further indicated that strict funding caps on the proposed deal would have exposed Eli Lilly to disproportionate financial risk. Simons added that the outcome would likely impede efforts to secure PBS listing for Mounjaro for other conditions, such as obesity or obesity-related diseases. The company noted that more than 100 medications recommended for subsidies have not progressed to PBS listing in the last five years. In a separate development, the PBAC recommended in December that semaglutide (sold as Wegovy) be subsidized for patients with obesity and heart disease who have experienced a heart attack, stroke, or have symptomatic peripheral arterial disease. The World Health Organization last year included Mounjaro on its list of essential medications for Type 2 diabetes and urged governments, including Australia, to make GLP-1 receptor agonist drugs more affordable for people with obesity. Federal Health Minister Mark Butler was contacted for comment but has not yet provided a response.

Conclusion

Eli Lilly’s refusal to accept the government’s funding terms means that a large cohort of Type 2 diabetes patients will continue to pay full price for Mounjaro, and the prospect of future subsidization for obesity treatment remains uncertain.

Vocabulary Learning

cohort
A group of individuals sharing a particular demographic characteristic or experiencing the same event within a defined time period, often used in clinical or policy contexts.群組，指在特定時間內共享某種人口特徵或經歷相同事件的個體群體，常用於臨床或政策語境。
Example:Eli Lilly’s refusal to accept the government’s funding terms means that a large cohort of Type 2 diabetes patients will continue to pay full price for Mounjaro.
disproportionate financial risk
A risk that is excessively large or unbalanced relative to the potential benefit, exposure, or market conditions.不成比例的財務風險，指相對於潛在收益、風險敞口或市場條件而言過大或不平衡的風險。
Example:The company indicated that strict funding caps on the proposed deal would have exposed Eli Lilly to disproportionate financial risk.
equity of access
The principle of ensuring fair and just distribution of resources or services, removing barriers based on cost or socioeconomic status.公平可及性，指確保資源或服務分配公平公正，消除因費用或社會經濟地位造成的障礙。
Example:The committee concluded that PBS listing would improve equity of access, particularly for patients for whom cost is a barrier.
glycemic control
The regulation of blood glucose levels within a target range, especially in the management of diabetes.血糖控制，指將血糖水平維持在目標範圍內的調節過程，尤其用於糖尿病管理。
Example:The committee noted that some patients do not achieve adequate glycemic control with currently subsidized therapies.
impede efforts
To hinder, obstruct, or delay progress toward a specific goal or initiative.阻礙努力，指妨礙、阻撓或延遲達成特定目標或計劃的進展。
Example:Simons added that the outcome would likely impede efforts to secure PBS listing for Mounjaro for other conditions, such as obesity.

Sentence Learning

The Pharmaceutical Benefits Advisory Committee (PBAC) recommended on Friday that tirzepatide, a once-weekly injectable medication marketed as Mounjaro, be listed on the Pharmaceutical Benefits Scheme (PBS) for adult patients with inadequately controlled Type 2 diabetes.
This sentence features a subjunctive mood in the that-clause ('that tirzepatide... be listed'), where the verb 'be' is in the base form, a hallmark of formal recommendation structures. It also contains a non-restrictive appositive ('a once-weekly injectable medication marketed as Mounjaro') that provides parenthetical elaboration, and a post-modifying prepositional phrase ('with inadequately controlled Type 2 diabetes') that adds specificity. 主句為 'The PBAC recommended... that... be listed'，其中 'that' 引導的從句使用虛擬語氣（be listed），表示建議；同位語 'a once-weekly injectable medication...' 補充說明 tirzepatide；介詞短語 'with inadequately controlled Type 2 diabetes' 修飾 patients，體現高密度信息承載。
The committee also observed that tirzepatide is currently available through the private market and concluded that PBS listing would improve equity of access, particularly for patients for whom cost is a barrier.
This sentence employs a complex parallel structure with two coordinated that-clauses ('observed that...' and 'concluded that...'), each containing its own subordinate content. The second clause features a relative clause with a prepositional fronting ('for whom cost is a barrier'), which is a formal and sophisticated alternative to 'who cost is a barrier for'. The adverb 'particularly' adds a focusing nuance. 主句 'The committee also observed... and concluded...' 連接兩個 that 引導的賓語從句；第二個從句內含 'for whom' 引導的定語從句，屬於介詞前置的正式結構，修飾 'patients'，體現句法複雜性。
Manny Simons, Eli Lilly’s general manager for Australia and New Zealand, stated that the government’s offered price was lower than prices agreed in other countries and included conditions the company deemed “unrealistic and unviable.”
This sentence contains a reduced relative clause ('prices agreed in other countries'), where 'that were' is ellipted, compressing information. It also features a nested relative clause ('conditions the company deemed...') without a relative pronoun, which is a hallmark of advanced ellipsis. The use of quoted adjectives ('unrealistic and unviable') adds rhetorical emphasis. 主句 'Manny Simons... stated that...'；第一個 that 從句內含 'agreed in other countries' 為省略關係代詞的被動分詞短語，修飾 'prices'；第二個 that 從句內含 'the company deemed...' 為省略 that 的定語從句，修飾 'conditions'，體現省略與壓縮結構。
The company further indicated that strict funding caps on the proposed deal would have exposed Eli Lilly to disproportionate financial risk.
This sentence uses the third conditional structure ('would have exposed') to express a hypothetical past outcome that did not occur, indicating a counterfactual scenario. The noun phrase 'strict funding caps on the proposed deal' is lexically dense, with multiple pre-modifiers ('strict', 'funding') and a post-modifier ('on the proposed deal'). 'Disproportionate financial risk' employs a nuanced adjective to convey imbalance. 主句 'The company further indicated that...'；that 從句使用 'would have exposed' 表達與過去事實相反的假設（第三條件句），主語 'strict funding caps' 帶有前置形容詞 'strict' 和後置介詞短語 'on the proposed deal'，詞彙密度高。
The World Health Organization last year included Mounjaro on its list of essential medications for Type 2 diabetes and urged governments, including Australia, to make GLP-1 receptor agonist drugs more affordable for people with obesity.
This sentence features a parallel verb structure ('included... and urged...') with a complex object complement in the second part: 'urged governments... to make... drugs more affordable'. The phrase 'including Australia' is a parenthetical insertion that adds specificity without disrupting flow. The infinitive phrase 'to make GLP-1 receptor agonist drugs more affordable' contains a causative structure ('make + object + adjective complement'), which is a sophisticated syntactic pattern. 主句 'The World Health Organization... included... and urged...' 並列兩個動詞；第二個動詞 'urged' 後接賓語 'governments' 及插入語 'including Australia'，再接不定式短語 'to make... more affordable'，其中 'make' 為使役動詞，後接形容詞補足語 'more affordable'，體現高階句法。