Is Wegovy or Mounjaro covered by insurance in Belgium?

On 3 June 2026, Belgium's health minister confirmed he would not approve reimbursement for Wegovy as an obesity treatment, following a negative opinion from INAMI's own drug-reimbursement commission — Belgium joins Germany, the Netherlands and Denmark on the 'no' side of this question, not France's. But the more consequential change for most Belgians with a semaglutide prescription arrived a few months earlier and from the opposite direction: since 1 February 2026, even the diabetes indication that has been reimbursed for years now requires an insurer's prior sign-off, after INAMI's own figures showed a surge in spending it attributes largely to fraud and off-label diversion.

The short version

Semaglutide (Ozempic, and since 1 July 2025 Wegovy) and tirzepatide (Mounjaro) are approved prescription medicines in Belgium, sold in pharmacies. For the diabetes indication, both have been reimbursed for years. For obesity specifically, the answer as of this review is no: on 3 June 2026, Health Minister Frank Vandenbroucke confirmed he would not approve reimbursement for Wegovy, following a negative opinion from INAMI's Commission de Remboursement des Médicaments (CRM) — the same body whose favourable opinion is what triggers reimbursement in Belgium's system. Mounjaro's obesity-specific indication has not had a separate reimbursement request decided publicly either; it remains, like Wegovy, a cash purchase for weight loss. Separately — and arguably more consequential for the much larger number of Belgians already reimbursed for the diabetes indication — INAMI tightened the reimbursement rules for that indication from 1 February 2026, after its own figures showed a spending surge it attributes largely to fraud and off-label diversion toward weight loss. The two stories are easy to conflate but are legally and administratively separate.

Why Wegovy was turned down

Novo Nordisk brought Wegovy to Belgian pharmacies on 1 July 2025, priced freely by pharmacy at roughly €169–€360 a month, while its reimbursement dossier sat with INAMI. On 3 June 2026, Minister Vandenbroucke — who described the call as "not straightforward" — announced he was following the CRM's negative opinion rather than overriding it. The reasoning reported from the minister's own statement and the CRM's opinion combines clinical and budgetary grounds: a quality-of-life benefit the commission judged insufficiently demonstrated, weight regain once treatment stops, frequent gastrointestinal side effects, and a structural objection that reimbursing Wegovy would set a precedent for an entire class of obesity drugs — not just this one product. On the budget side, the minister cited an estimate that treating every Belgian who would qualify could cost several billion euros a year, a figure reported as equivalent to more than half of the country's total annual medicines budget — the scale of that estimate reflects Sciensano's own finding that roughly one in six Belgian adults lives with obesity. As of this review, no public timeline for reconsidering the decision has been announced.

Novo Nordisk's response

Novo Nordisk publicly pushed back the following day, calling the lack of reimbursement a missed opportunity that risks unequal access — patients able to pay privately can still get the drug, those who can't, can't — and, separately, a risk factor for less safe, unsupervised use by people seeking a cheaper route. The company was quoted putting it directly: "the question is not whether Belgium can afford to reimburse an obesity treatment, the question is whether Belgium can afford not to do so," arguing that untreated obesity's downstream costs (hospital admissions, complications, disability) are also real budget items, just ones that don't show up in a pharmaceutical-budget line. The company called for continued discussion among policymakers, healthcare providers and patient organizations rather than announcing an appeal.

The diabetes indication is unaffected — but got harder to access, for a different reason

None of the above touches Ozempic's or Mounjaro's established reimbursement for type 2 diabetes, which continues. What has changed is how easily that reimbursement can be claimed, and the reason is specific: INAMI's own figures show semaglutide reimbursement spending rising from roughly €60.7 million to €69.5 million over an eleven-month period, with dispensed doses nearly doubling from about 5.8 million to 9.2 million, and reimbursement spending across the broader non-insulin antidiabetic drug class reaching roughly €275 million in 2024 — a 16.5% increase in a single year. INAMI's own account of that increase points to fraud alongside genuine clinical demand: falsified prescriptions, improper invoking of a "diabetes care pathway" status the patient didn't actually have, and "medical shopping" across multiple prescribers to obtain reimbursed doses for weight loss rather than diagnosed diabetes.

INAMI responded in steps. From May 2025, pharmacists were required to verify that a patient genuinely had an active diabetes care pathway on file before applying third-party-payer (reimbursed) pricing at the counter. Mounjaro was already moved onto its own prior-authorization footing around October 2025; from 1 February 2026, INAMI consolidated the other five brands onto that same footing — prior authorization from the patient's own mutualité/mutualiteit (health insurance fund) advising physician became mandatory for reimbursement of Ozempic, Rybelsus, Trulicity, Victoza and Xultophy too, for every patient, including those already established in a diabetes care pathway. A prescription that simply references the care pathway is no longer sufficient by itself; the fund's own doctor has to sign off before the pharmacist can apply reimbursed pricing. A four-month transition period from 1 October 2025 was built in specifically so patients already being treated wouldn't see a coverage gap while the new authorization process came online.

How this compares elsewhere in the EU

Belgium's "no" sits alongside Germany's, Denmark's, Poland's and, most recently, Sweden's — plus the Netherlands' "not yet" — France remains, as of this review, the only EU country that reimburses a GLP-1 drug for obesity itself rather than diabetes. This site's France page covers that full comparison in detail; the short version is that Germany's G-BA has formally excluded Wegovy as a "lifestyle drug," a Dutch reassessment of an earlier negative recommendation was still ongoing as of its most recent public update, Denmark's health ministry has cited its own multi-billion-dollar cost estimate as the reason it hasn't moved, Poland's own technology-assessment agency recommended against reimbursing Mounjaro for obesity in June 2026 over durability-of-effect and budget concerns, without disputing the drug's efficacy, and Sweden's benefits agency (TLV) rejected Wegovy for adults in February 2026 — because it couldn't guarantee a restricted eligibility group would stay restricted once the drug was subsidized — and, on separate reasoning, for adolescents both then and again on a narrower re-application in July 2026. Belgium's CRM opinion adds a distinct angle to that same list: an explicit "precedent for the whole drug class" objection, on top of the clinical and budgetary reasoning other countries have leaned on individually.

What this doesn't change

Wegovy and Mounjaro remain lawfully available in Belgium on a private prescription regardless of indication — a doctor can still prescribe either for weight loss, it simply won't be reimbursed, the same "approved isn't the same as covered" gap described on this site's Canadian insurance page and French reimbursement page. And the February 2026 prior-authorization rule doesn't remove diabetes coverage for anyone who actually has type 2 diabetes and goes through the new sign-off step — it adds a checkpoint aimed at claims INAMI says shouldn't have been reimbursed in the first place, not a cut to legitimate diabetes care. See Semaglutide and Tirzepatide for the underlying drugs' evidence and approval history.