Operation Obélix: Judicial Police Trace €250 Million Ozempic Fraud Against Portugal's SNS
Porto's Judicial Police estimates that half of the €505 million the SNS spent subsidising diabetes drugs between 2020 and 2025 was diverted to off-label weight-loss prescriptions — a fraud concentrated in Ozempic that Lisbon only closed by regulation in February 2026.
Portugal's Judicial Police (PJ) believes the country's National Health Service has been bled for more than €250 million by a systematic fraud involving Ozempic and related type 2 diabetes drugs, prescribed off-label as weight-loss shortcuts and billed to the State. The estimate was disclosed this week as part of Operation Obélix, an investigation opened in 2020 by the PJ's Porto directorate that is still producing new arrests.
Half of state-subsidised diabetes spending allegedly diverted
Between 2020 and 2025, the Serviço Nacional de Saúde spent approximately €505 million co-paying the cost of semaglutide-based medicines such as Ozempic, Rybelsus and Trulicity. PJ analysts who reconstructed five years of prescription billing concluded that roughly half of that sum was spent on people who did not meet the clinical criteria — overwhelmingly patients using the drugs to lose weight rather than to control type 2 diabetes.
The arithmetic is hard to explain any other way. Over the same period, SNS spending on these medicines rose 285 per cent, while the registered diabetic population grew only 12 per cent, from roughly 833,000 patients in 2020 to 936,000 in 2024. Clinicians contacted by investigators say the prescription trend cannot be reconciled with the epidemiology.
Regulator only closed the loophole in February
The timing matters. Until February this year, Ozempic was reimbursed by the SNS only for type 2 diabetes. Infarmed, Portugal's medicines regulator, extended formal co-participation to patients with obesity or high cardiovascular risk only at the start of 2026. For the five years covered by Operation Obélix, any prescription issued for pure weight loss was technically diverting public money — regardless of whether the patient paid the co-payment at the pharmacy counter.
Investigators say the abuse was not confined to patients. A phase of the same operation in November 2025 led to the arrest of a Porto-based endocrinologist, Graça Vargas, who allegedly charged around €200 in cash for each consultation and prescribed €9.7 million worth of these medicines, more than any other doctor in the country. The PJ estimated the SNS bill for her prescriptions alone at around €3 million.
Diabetic patients squeezed out of the supply
The knock-on effect on Portugal's actual diabetic patients has been severe. The Associação Protectora dos Diabéticos de Portugal has repeatedly warned over the past two years that patients prescribed Ozempic by SNS physicians were unable to fill prescriptions because community pharmacies had run out of stock, as off-label demand tore through the supply chain. Some chronic patients were forced to switch medication regimes mid-treatment.
For the SNS, the numbers disclosed by the PJ are the largest single pharmaceutical fraud figure ever attached to a Portuguese investigation. For context, the entire 2025 SNS outsourced agency-doctor bill — itself a source of political controversy this week — came in at €266.8 million. Operation Obélix, in other words, is of the same order of magnitude as a full year of emergency staffing costs.
What happens next
The case is still open: the PJ continues to cross-reference prescriptions, pharmacy dispensations and consultation records across Porto, Vila Nova de Gaia, Lousada, Santa Maria da Feira, Albufeira and Funchal. Further arrests of doctors and clinic owners are expected. The Ministry of Health, for its part, has said only that it is cooperating with the investigation; a formal parliamentary enquiry has not yet been requested.
Sources: Polícia Judiciária (Porto); ECO; Observador; Público.
