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c/glp1uk·posted 6 months ago by u/a1c_arc

[Question] Australia — has anyone got a straight answer on tier 3

Question Cold Box ×8

Australia — has anyone got a straight answer on tier 3. I would rather ask a basic question now than get this wrong quietly for two months.

Two years and four months on a tier 3 list. Referral date and every letter kept, which turned out to matter when the service reorganised.

Four pharmacies, four prices, same product, same month. The spread was larger than I expected and none of them were the headline offer.

GP said no in the spring, specialist said yes eighteen months later. Same person, same numbers.

That is everything I have. The rest is opinion and I have tried to keep it out.

752 up / 243 down76% upvoted23 commentsid 5f5bpe17 Jan 2026

23 comments

15 in this archive, depth 5

best — the order this archive was captured in

u/slow_logbook95 points·6 months ago

Discharge at goal, which nobody warns people about.

Specialist services in England are commissioned to deliver a defined intervention. Reaching goal is a successful outcome and it typically ends with discharge back to primary care. Whether prescribing continues after that is a local decision that varies, and plenty of members here have discovered it at the point of discharge rather than at the start.

The useful thing to do is ask early: what happens when I finish, and does prescribing continue in primary care in this area. Ask it in writing, keep the answer, and you will at least know which conversation you are heading for.

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u/pavel_kravchenko-6 points·6 months ago

Disagree. That is the pathway in one ICB and it does not generalise even to the next one over.

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u/a1c_arcOPT2D1 point·6 months ago

specialist service, not GP, for tier 3 in most of England

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[deleted]1 point·6 months ago

[deleted]

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u/a1c_arcOPT2D1 point·6 months ago

no referral links, ever, and that rule is why the pricing threads work

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u/a1c_arcOPT2D1 point·6 months ago

private and NHS pathways are not a ladder, they are separate routes

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u/vikram_mbeki1 point·6 months ago

Small fix — that is the Scottish pathway. The post is asking about England and the answer is different.

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u/milos_mensa1 point·6 months ago

the ICB decides the threshold and they are not the same across England

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u/ferran_krastev57 points·6 months ago

ask the pharmacy for the price list, not the headline offer

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u/units_not_mgsyringe math39 points·6 months ago

Scotland, Wales and Northern Ireland have their own arrangements. An answer that begins with "in England" should say so, and most of the confusion here comes from answers that do not.

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u/lane_watchermod · logistics30 points·6 months ago

Discharge from a specialist service at goal is a normal end point of that pathway. Whether prescribing continues in primary care afterwards is a local decision and is worth asking about at the start rather than at the end.

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u/mei_cardoso9 points·6 months ago

GP said no and specialist said yes is a very common sequence

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u/hassan_chowdhury12 points·6 months ago

This. The monthly pricing tracker is the most useful thing on this board and it works because nobody is allowed to link anything.

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u/crp_curious9 points·6 months ago

Careful, that pricing figure is a headline offer with conditions attached rather than the actual monthly cost.

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u/tomas_lehtinen46 points·6 months ago

England, Scotland, Wales and Northern Ireland are four different pathways

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UK-specific access: NHS tier-3 and specialist weight-management pathways, the two-year waiting-list reality, private prescription routes and their monthly cost, pharmacy stock, MHRA supply notices, and how the UK rules differ from the US conversation that dominates most of the internet.

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