Singapore: HSA Approval and Medication Assistance Fund Rules for GLP-1 Drugs

In Singapore, marketing approval and public subsidy are separate decisions. The Health Sciences Authority (HSA) decides whether a prescription medicine may be supplied and for which labelled uses, while the Ministry of Health's Drug Advisory Committee — advised by the Agency for Care Effectiveness (ACE) — decides which products receive assistance under schemes such as the Medication Assistance Fund (MAF). For GLP-1 drugs, those tracks have diverged.

According to HSA's new-drug-indication announcements, Wegovy (semaglutide) received an additional approval on 28 February 2025 for weight management in adolescents aged 12 years and above with obesity and body weight above 60 kg, as an adjunct to diet and physical activity, with a rule to discontinue and re-evaluate if BMI has not fallen by at least 5% after 12 weeks on the 2.4 mg or maximum tolerated dose.

On 22 August 2025, HSA further approved Wegovy to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and either obesity or overweight. Separately, on 6 November 2025, HSA approved an expanded Ozempic indication to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. Singapore's National Drug Formulary lists registered Ozempic, Wegovy, and Rybelsus products and notes availability across multiple public healthcare institutions.

ACE's December 2022 guidance on GLP-1 receptor agonist injections for type 2 diabetes recommended dulaglutide 0.75 mg and 1.5 mg for inclusion on the MAF from 1 February 2023 under defined dual- or triple-therapy criteria with oral agents or insulin. The same guidance states that MAF assistance does not apply to any formulations or strengths of liraglutide or semaglutide for treating type 2 diabetes mellitus.

The National Drug Formulary's semaglutide page restates that funding status: dulaglutide is recommended for MAF for the listed diabetes uses, while semaglutide is marked as not recommended for MAF assistance for type 2 diabetes. Approval to prescribe is therefore not the same as subsidy eligibility.

A clinician in Singapore may prescribe HSA-registered GLP-1 products for their labelled indications, but patients should not assume MAF help will apply to semaglutide. For diabetes, ACE's published guidance remains the clearest public statement that dulaglutide — not semaglutide — is the GLP-1 injection recommended for MAF. Anyone checking access should verify the current HSA Register of Therapeutic Products for labelled uses and the National Drug Formulary or ACE pages for subsidy status, and confirm out-of-pocket costs with the treating institution.