Heard at the parliamentary health committee, the president of APDP, José Manuel Boavida, considered that the fact that the co-payment for these medications in the case of type 2 diabetes is only foreseen for people whose BMI is higher than 35 “makes no sense”.

“The study itself that Infarmed based this decision on shows that people with a body mass index between 30 and 35 have better results, which is easy to understand because it is easier for a person with a little excess weight to lose weight than for a person with a lot of excess weight”, he explained.

José Manuel Boavida argued that “Infarmed should go further” in this co-payment, in the sense of deciding on co-payment in cases of obesity, defining specific criteria.

In the case of type 2 diabetes, he argued that co-payment should be for all people who are overweight: “I’m not even 30 [for BMI], which is obesity, because, as you know, all these indexes are calculated artificially, by consensus”.

“I would say a body mass index higher than 28, which is what some countries already use in the case of diabetes”, he added.

Accessing medication

When asked about the difficulty diabetics have in accessing these medicines in pharmacies – since they are also being used, albeit without co-payment, in cases of obesity – he said that the situation is “very serious”.

“The laboratory has a ‘cap’ [maximum annual limit set for the State’s expenditure on co-payment] beyond which it receives nothing and, therefore, does not put them in pharmacies. (…) This is an issue that Infarmed has to negotiate”, he considered, recalling that in the United States – “where prices are exorbitant” – the Senate called on pharmaceutical company managers to renegotiate prices.

“Here I would also suggest that they call on the managers of these commercial companies and see if they are willing to lower prices, thus allowing wider access to a larger population. By selling much more, the end result would certainly not be unfavourable to them”, he stated.

In July, taking into account the difficulty of accessing these medicines in pharmacies, Infarmed made recommendations to manage the shortage of these drugs, reminding that they should not be prescribed to patients who are not diabetics and advising against their use of ‘off label’ for weight loss.

José Manuel Boavida also said that there are companies that already sell this medication online – without a medical prescription – in a process that he said could have “very big repercussions”.

“Just to give an example, testosterone is the most sold medicine online and (…) it is almost unavailable in pharmacies. It is practically all sold online”, he stated, adding: “the future may bring us some complex issues to resolve”.

The official was also questioned by the deputies about the importance of prevention in diabetes, recalling that he had already proposed the creation of the Diabetes Prevention Institute and challenging the Ministries of Health and Finance to support the implementation of this idea.