Access

What you can actually get, where

Approval is not availability, and availability is not affordability. A brand can hold a Europe-wide authorisation and never be sold in your country, or be sold and not reimbursed, or be reimbursed only for diabetes when you want it for weight. Each page below is written in that country’s own language against its own regulator, because a translated American page would be confidently wrong about every one of those things.

AU AustraliaTwo separate gates, TGA registration and PBS/PBAC subsidy, layered on top of a severe multi-year semaglutide shortage and a 2024 ban on compounded GLP
BR Brazil / BrasilNo Brasil o remédio existe, o preço tem teto legal e o SUS não entrega nenhum deles. O acesso é privado, com receita retida.
CA CanadaCanada is not the US market with a currency conversion applied. A different regulator, a provincial patchwork of public payers, and a licence split be
CN China / 中国中国有两道各自独立的门：NMPA 批准决定医生能不能开，国家医保目录决定基金报不报。第二道门对减重适应症一律关闭。同时中国还有一批本土研发的药，境外根本买不到，却是中国患者的现实选项。
FR FranceEn France, la question n'est pas quelle marque choisir mais laquelle existe. La liste réelle est plus courte que la liste américaine, et depuis le 15
DE Germany / DeutschlandIn Deutschland entscheidet nicht die Wirksamkeit über die Erstattung, sondern die Zulassungsindikation. Dieselbe Substanz ist auf Kassenrezept verordn
IN IndiaA patent that expired roughly a decade earlier in India than in the US or EU turned the country into the cheapest legitimate market for semaglutide in
IE IrelandIreland's regulator question is the easy half. Ireland is in the EU, so a European Commission authorisation is a Irish authorisation the same day, no
IT Italy / ItaliaIn Italia la domanda non è quale farmaco è migliore, ma sotto quale indicazione lo si prescrive. Da lì discende la classe AIFA, e dalla classe discend
JP Japan / 日本承認のゲートと保険のゲートは別物で、日本は保険のゲートに BMI・合併症・施設要件・栄養指導期間・投与を止める計画までを書き込んでいる。その厳しさが、そのまま自由診療市場の大きさの理由になっている。
MX Mexico / MéxicoUn registro sanitario de COFEPRIS no es lo mismo que cobertura del sector público, y el mercado privado que llena ese vacío convive con un problema re
NL Netherlands / NederlandEen EU-handelsvergunning maakt een merk beschikbaar, maar vergoeding via de basisverzekering is een aparte, per-indicatie beoordeling door Zorginstitu
PL Poland / PolskaDwie osobne bramki. Rejestracja jest unijna i szeroka, refundacja jest polska i wąska: na wykazie Ministra Zdrowia stoją tylko dwa leki GLP-1, oba wył
PT PortugalTer autorização europeia e estar à venda numa farmácia portuguesa são duas coisas diferentes. Em Portugal, quatro das nove marcas desta classe não têm
KR South Korea / 대한민국허가와 급여는 별개의 문을 통과해야 한다. 한국에서는 첫 번째 문은 대부분 열려 있고, 두 번째 문은 비만 적응증에 대해 사실상 닫혀 있다. 그래서 약값 전액이 환자 부담이 된다.
ES Spain / EspañaDos puertas separadas, autorización EMA/AEMPS y financiación SNS vía CIPM, con un visado de inspección que decide caso por caso incluso dentro de los
SE Sweden / SverigeTvå grindar som ofta blandas ihop: godkännandet, som avgör om läkemedlet får skrivas ut, och förmånen, som avgör om någon annan än du betalar. I Sveri
TR Turkey / TürkiyeÜç ayrı kapı var ve üçü de farklı yerde kapanıyor: TİTCK ruhsatı, ürünün fiilen piyasaya verilmiş olması, ve SGK ödemesi. Kilo endikasyonunda üçüncü k
GB United KingdomTwo separate gates, MHRA licensing and NICE/NHS funding, and a phased NHS rollout that is explicitly rationed by BMI and comorbidity count rather than
VN Vietnam / Việt NamViệt Nam công khai ít dữ liệu hơn châu Âu hay Bắc Mỹ, nhưng phần công khai thì tra được và chính xác. Việc đọc đúng phần đó, đồng thời nói rõ phần khô

Why these are not translations. The reimbursement rule, the prescription route and the brand names all change at the border. Tirzepatide for weight is Zepbound in the United States and Mounjaro in the United Kingdom, and a translated page would have told every British reader to ask for a product that does not exist there.

Educational information, not medical advice. Regulatory and reimbursement positions change; each page carries the date its sources were read.