The Portuguese Diabetes Protection Association (APDP) has called the state's 15% reimbursement of obesity medicines insufficient, warning that the condition cannot be tackled through short-term thinking. The criticism came a day after a government order set out the terms under which the state will share the cost of these drugs, according to Canal S+.
Under the published rules, patients qualify only if they are enrolled in a specific follow-up plan at a hospital and the prescription comes from an endocrinologist, an internal medicine specialist or a paediatrician. Patients must also be monitored by the non-surgical hospital care unit of their local health unit's multidisciplinary obesity team, within a model that includes physical activity planning alongside nutritional and psychological support.
Why it matters
The APDP argues that obesity sits behind type 2 diabetes and that treating it properly has consequences far beyond weight loss. In a statement, the association said addressing obesity also means treating more than 200 associated conditions and preventing future complications, as reported by Canal S+.
The group said preventing obesity could cut new cases of type 2 diabetes by 80% and allow thousands of people already living with diabetes to go into remission. It framed the wider benefit in terms of fewer patients needing care for kidney failure, amputations, blindness and low vision, as well as fewer heart attacks, strokes and hospital admissions.
Hospital-only access draws fire
José Manuel Boavida, who heads the APDP, said confining obesity treatment to hospitals would "generate chaos" by adding bureaucracy to primary care, since patients would need to be referred for a hospital appointment. He also said a 15% share is far too little, arguing that broader patient access to the medicines would let the state negotiate better prices with manufacturers and secure affordable coverage across all levels of care.
Carolina Neves, a doctor with the association, said tying reimbursement to those who manage to get a hospital consultation preserves inequalities and undermines fair access. She also objected to the 12-month limit on coverage, saying such a cap is unsuitable for any chronic disease, obesity included.
The APDP's intervention follows criticism from family doctors. Nuno Jacinto, president of the Portuguese Association of General and Family Medicine, told Lusa that the government was giving with one hand and taking with the other by narrowing access, leaving out primary care and clogging hospital appointments. He said the approach creates an enormous barrier to access while appearing to promise follow-up for obesity patients in Portugal.
Separately, HealthNews reported that private hospitals are debating how obesity treatment should be handled.
The government has not indicated whether it will revisit the criteria. Watch for whether the APDP and family doctor groups push for the rules to be reopened, and whether primary care is eventually brought into the reimbursement scheme.
