A data story · HTA Outcomes

One molecule. Eight verdicts.

Tirzepatide reached three HTA agencies with the same pivotal trials. Scroll through what each of them decided, and how long the last yes took.

Scroll ↓
July, October 2023

The first split.

Australia moved first: in July 2023 the PBAC said no, calling the cost-effectiveness case high, inadequately justified and uncertain.

Three months later NICE said yes, with conditions: recommended for type 2 diabetes, but only where stricter clinical criteria are met. Same evidence base, opposite headlines.

2024

Britain settles. Australia says no again.

The SMC accepted tirzepatide twice with restrictions, for diabetes in April and weight management in June. In December, NICE recommended it for obesity outright.

The PBAC saw a narrower resubmission built around severe obesity and priority populations. Still no.

July 2025 · PBAC

The deferral that signalled a deal.

At its third meeting the PBAC agreed tirzepatide was more effective than semaglutide, then deferred anyway: the price and the financial risk to the PBS were the sticking points, not the science.

In our database of 1,957 PBAC decisions, 63% of deferrals convert to a yes. A deferral is usually a negotiation, not a rejection.

March 2026 · PBAC

Four meetings to yes.

With revised pricing and a new risk-sharing arrangement, the PBAC recommended tirzepatide for type 2 diabetes.

That is 32 months after the first submission and 29 months after NICE's first yes. Every month of it was a private-market-only launch in Australia.

The verdict

None of this was unusual.

Across the 23,196 decisions in our five-agency database, 42% of PBAC rejections are eventually reversed, and 262 molecules have received opposite verdicts from different agencies.

Divergence and resubmission are not noise. They are the base rates your launch sequence should be planned against.

Decision histories, by molecule.

Every dot above is a published agency outcome, read from our five-agency HTA database: sixteen HTA agencies, 12,922 decisions linked by molecule. The same engine supplies base rates for approval likelihood, resubmission and deferral conversion.

Explore tirzepatide in the database Next story: What 97% looks like