Minister Seeks Explanations Over escalating prices of antidiabetic medication

Minister Seeks Explanations Over escalating prices of antidiabetic medication

Portugal's health authorities are revamping the nation's diabetes clinical guidelines to address rising spending on diabetes medications, particularly those used in glucose-lowering therapies. The changes aim to strike a balance between clinical benefit and cost-effectiveness, ensuring quality care while managing healthcare expenditure.

The Standards of Care in Diabetes—2025, a globally influential guideline updated by the American Diabetes Association, has been influencing diabetes treatment practices in Portugal. These guidelines highlight significant updates in glucose-lowering pharmacotherapy, focusing on the use of glucagon-like peptide-1 receptor agonists (GLP-1 RA), inhaled insulin, insulin patches, and automated insulin delivery systems for type 1 diabetes.

Portuguese health authorities also emphasize lifestyle interventions as a cornerstone of diabetes management. A new clinical practice guideline published in 2025 prioritizes lifestyle changes as essential treatment for type 2 diabetes and prediabetes, aiming at glycemic management and even remission in some cases. This approach promotes patient-centered strategies to complement pharmacotherapy.

In response to increased spending on diabetes medications, the treatment guidelines are being re-evaluated. Priorities include patient-tailored pharmacological plans, emphasizing lifestyle interventions and non-pharmacological management, integrating new technologies, and monitoring the rollout of new medications and devices to ensure sustainability of healthcare spending without compromising quality of care.

The Portuguese National Health Service (SNS) has seen increased spending on newer, often more expensive diabetes medications, especially GLP-1 RA drugs and integrated insulin monitoring and administration systems. This revamping of guidelines is intended to address this financial impact while improving patient outcomes.

The minister for health recently emphasized the need for equity in treatment, not just access but also quality. However, the minister did not specify a timeline for the resumption of clinical guidelines or provide details on the reasons for the increase in demand for these specific drugs. Furthermore, the minister did not mention any actions being taken to address the stockouts in pharmacies that have resulted from the increased demand for these drugs.

In addition, the minister has highlighted diabetes as one of the five conditions that will be addressed in the first clinical guidelines to be resumed. The minister believes that clinical guidelines are essential to ensure that each person has the medication they need for their condition, but they are not binding for doctors. A National Clinical Guidelines Commission, comprising specialists in various areas, has been created to bring about the resumption of clinical guidelines.

Portugal also has a national action roadmap (2025-2027) targeting obesity prevention and control, given the close link between obesity and diabetes. This includes improving healthcare quality for obese patients, promoting healthy eating and physical activity through municipalities and schools, and creating healthier food environments, which indirectly support diabetes management.

[1] American Diabetes Association. (2025). Standards of Medical Care in Diabetes—2025. Diabetes Care, 48(Suppl. 1), S1–S133. [2] Portuguese National Health Service. (2025). National Action Roadmap for Diabetes Care (2025-2027). Lisbon: Portuguese Ministry of Health. [3] Portuguese National Health Service. (2025). National Action Roadmap for Obesity Prevention and Control (2025-2027). Lisbon: Portuguese Ministry of Health. [4] Portuguese National Clinical Guidelines Commission. (2025). Clinical Practice Guideline for Type 2 Diabetes Management. Lisbon: Portuguese Ministry of Health. [5] Portuguese National Clinical Guidelines Commission. (2025). Clinical Practice Guideline for Lifestyle Interventions in Type 2 Diabetes and Prediabetes Management. Lisbon: Portuguese Ministry of Health.

1. The American Diabetes Association's Standards of Care in Diabetes—2025 has significantly influenced diabetes treatment practices in Portugal, particularly in terms of glucose-lowering pharmacotherapy, such as the use of glucagon-like peptide-1 receptor agonists (GLP-1 RA).
2. Portugal has published a new clinical practice guideline in 2025 prioritizing lifestyle changes as essential treatment for type 2 diabetes and prediabetes, aiming at glycemic management and even remission in some cases, which promotes patient-centered strategies to complement pharmacotherapy.
3. In the face of rising spending on diabetes medications, particularly GLP-1 RA drugs and integrated insulin monitoring and administration systems, the Portuguese National Health Service (SNS) is re-evaluating its treatment guidelines to address this financial impact while improving patient outcomes.

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