SNS to Reimburse 15 Percent of Obesity Medicines From February 2027, but Only for Patients Followed by Hospital Obesity Teams

The State will pay 15 percent of the price of prescription obesity medicines for patients treated by a hospital obesity team within the Serviço Nacional de Saúde (National Health Service, SNS). A Portaria (ministerial order) n.º 464/2026/1, published in the Diário da República (official gazette) on 22 October, sets the rules. It takes effect 120 days after publication, which puts the start in February 2027.

Who qualifies

The order sits inside the Percurso de Cuidados Integrados para a Pessoa com Obesidade (Integrated Care Pathway for People with Obesity, PCIPO), which Despacho (order) n.º 13066/2025 created in November 2025. To get the reimbursement, a patient must:

• be an SNS user with an active clinical file in the pathway, followed by the hospital, non-surgical arm of the Equipa Multidisciplinar de Obesidade (Multidisciplinary Obesity Team, EMO) at their Unidade Local de Saúde (Local Health Unit, ULS);
• be in a programme that combines nutrition support, a physical activity plan and psychological care;
• meet the pathway's own eligibility and prescribing criteria;
• have the prescription written electronically by a specialist in endocrinology, internal medicine or paediatrics who belongs to that hospital team, with the special regime named on the prescription.

The medicines are dispensed only in community pharmacies. The 15 percent lasts 12 months from the first dispensing, the minimum time the pathway allows to judge whether treatment has worked, and each renewal depends on a check that the patient is meeting their treatment goals. Infarmed (the national medicines authority) will monitor use and results.

The order does not name any medicine. It applies to obesity drugs that win a favourable reimbursement decision under Decree-Law n.º 118/2026, whose Article 35 defines band D, the band used here, as 15 percent of the retail price or of the reference price.

The clinical bar is high

According to the pathway of the Direção-Geral da Saúde (Directorate-General of Health, DGS), the route starts at the health centre: once obesity is diagnosed, the primary care unit must pass the patient to the obesity team, and the hospital arm takes people whose comorbidities are not under control or who need more specialised care. An Infarmed study from December 2025 sums up the pathway's criteria for drug treatment: in general a body mass index of 35 or more with at least one illness linked to excess fat, plus 12 months of nutrition, exercise and psychological support that have not worked. It estimated that 170,405 to 180,880 adults could qualify.

What patients would still pay

Infarmed's study priced a first year of treatment at 1 November 2025 retail prices, including temporary price cuts on Mounjaro and Wegovy. Under band D, the patient's share came to:

• Mounjaro (tirzepatide): 3,233.42 euros of 3,804.02 euros;
• Saxenda (liraglutide): 2,414.79 euros of 2,840.93 euros;
• Wegovy (semaglutide): 2,241.52 euros of 2,637.08 euros;
• Mysimba (bupropion and naltrexone): 1,112.51 euros of 1,308.84 euros;
• Orlistat 120 mg: 550.80 euros of 648.00 euros.

Those are estimates, and Infarmed said prices could change after the formal assessment. Decree-Law 118/2026 adds 15 points in band D for pensioners on low incomes; the order does not say how that applies here.

What it means for you

Anyone prescribed these drugs privately, or treated outside an SNS hospital obesity team, gets no help under this order. Notícias ao Minuto reported that family doctors had asked the DGS whether they could prescribe, arguing that keeping them out narrows access; the order leaves prescribing with hospital specialists. If you think you qualify, the starting point is your family doctor. Infarmed already receives about one suspected side-effect report a day for GLP-1 weight-loss and diabetes drugs.