What the ordinance sets out

The Portuguese government has published an ordinance (portaria) creating a special co-payment regime for medicines used to treat obesity. Under it, the state will cover 15% of the cost of these drugs for patients enrolled in a specific hospital follow-up plan, and the regime takes effect in February 2027. The co-payment lasts 12 months, counted from the first dispensing, which matches the minimum intervention period the Integrated Care Pathway for Persons with Obesity (PCIPO) sets for judging whether treatment has worked. Renewals depend on the periodic review foreseen in that pathway, and the prescribing doctor must record the result in the electronic clinical file. The drugs can only be dispensed in community pharmacies, and Infarmed will monitor how the regime is applied.

Who qualifies

Patients must be followed in the non-surgical hospital care unit of the Multidisciplinary Obesity Team (EMO) of their local health unit (ULS), within a multidisciplinary approach that includes physical activity planning and nutritional and psychological support. They also need an active clinical file under the PCIPO, defined last year as a central measure of the National Programme for the Prevention and Management of Obesity (PNPGO), coordinated by the DGS. Prescriptions must come from endocrinologists, internal medicine specialists or paediatricians who integrate the EMO unit of the relevant ULS. The decree places the drugs in co-payment band D.

Patient groups criticise the limits

Carlos Oliveira, president of the Associação de Doentes Obesos e Ex-Obesos de Portugal (Adexo), said a 15% discount was not enough, since most people with obesity have no surgical indication and still cannot afford the drugs at current prices. He said the scheme would leave Portugal behind its European peers.

“We are going to be laughed at by the rest of Europe, because countries concerned about obesity are co-paying at 50%, 60% and 100%.”

Oliveira also asked how people in health units without multidisciplinary teams would reach treatment, and what would happen to patients followed by health subsystems such as ADSE or SAMS, who are not registered in the SNS or the EMO. He added that the scheme undermines the PCIPO, which had planned to integrate primary care.

Family doctors warn of clogged clinics

Nuno Jacinto, president of the Portuguese Association of General and Family Medicine (APMGF), said the government was granting access with one hand while restricting it with the other. He noted that many ULS lack endocrinologists or internal medicine doctors, two of the specialties authorised to prescribe, and said that excluding primary care and family doctors would limit access further.

“We will have to refer every obese patient with a therapeutic indication to this hospital appointment, that is, we will clog these consultations with thousands of patients.”

Jacinto said the referral model would overload hospital consultations. Family doctors had earlier asked the DGS to clarify whether they could prescribe the drugs under the PCIPO announced last year.

Timing

The ordinance was published on Thursday, 22 October 2026, and takes effect in February 2027. Its co-payment period and renewal rules apply from the first dispensing, and Infarmed is charged with monitoring its application once it is in force.