KUALA LUMPUR, April 20 — Perodua Manufacturing Sdn Bhd has instructed its panel clinics to stop prescribing and dispensing GLP-1 and GIP/GLP-1 injectables to the company’s staff and dependents.
In a March 17 letter to panel clinics, as sighted by CodeBlue, the local car manufacturer said it fully acknowledged the clinical efficacy and therapeutic value of these medications in diabetes management.
“However, due to evolving internal guidelines and the need for further evaluation on the usage, we have decided to defer the coverage for the time being,” wrote Noreha Jaafar, acting manager of the human resource and administration division at Perodua Manufacturing.
“While we are evaluating the policy, you may continue to prescribe other oral hypoglycaemic agents which demonstrate similar efficacy on treating and managing diabetes to our staff.
“Please be advised that the use of similar injectables or any latest formulary requires prior authorisation and approval from our Health and Wellness Centre.”
GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity), as well as dual GIP/GLP-1 receptor agonists like tirzepatide (Mounjaro), are breakthrough medicines that treat type 2 diabetes and obesity or chronic weight management.
Federation of Private Medical Practitioners’ Associations Malaysia (FPMPAM) president Dr Shanmuganathan TV Ganeson explained that although metformin remains an appropriate first-line therapy for many patients with type 2 diabetes, modern diabetes care has moved beyond a one-size-fits-all approach.
“GLP-1 receptor agonists and dual GIP/GLP-1 therapies are prescribed because they deliver clinically meaningful benefits that older agents do not—namely significant weight reduction, lower hypoglycaemia risk, and proven cardiovascular and renal protection in appropriate patients,” Dr Shanmuganathan told CodeBlue.
“In many cases, these are not ‘premium’ or optional therapies, but medically indicated treatments aligned with international guidelines. Suggesting that doctors should default to older, cheaper drugs disregards current standards of care and the complexity of managing modern diabetes.”
Dr Shanmuganathan pointed out that although GLP-1 and dual GIP/GLP-1 therapies are costly at around RM800 to RM1,000 a month and increasingly used for weight loss, they remain clinically indicated and guideline-supported for patients with type 2 diabetes, particularly those with cardiovascular risk or poor glycaemic control.
“FPMPAM would view broad, non-clinically nuanced restrictions on specific drug classes as a direct intrusion into clinical decision-making,” he said.
“While cost management is a legitimate concern, it does not justify blanket directives that override medical judgment. Such policies risk reducing patient care to cost considerations alone and may compel doctors to deviate from evidence-based practice.
“Clinical decisions must remain grounded in individual patient needs, guided by professional standards—not dictated by administrative or financial directives.”
The general practitioner (GP) explained that the relationship between obesity and type 2 diabetes is well established and causal, not incidental.
“Excess adiposity drives insulin resistance, accelerates disease progression, and increases the risk of complications,” said Dr Shanmuganathan.
“Therapies such as GLP-1 and GIP/GLP-1 agents are effective precisely because they target both hyperglycaemia and the underlying driver—excess weight. Treating glucose in isolation while ignoring obesity is clinically incomplete and, in many cases, suboptimal care.
“It is no longer tenable to frame obesity as merely a ‘lifestyle issue’. It is a chronic, relapsing disease recognised by major medical bodies worldwide. Failure by payors to acknowledge this risks perpetuating poorer outcomes and higher long-term costs through avoidable complications.
“In this context, restricting access to therapies that address both conditions simultaneously may be short-sighted from both a clinical and health economics perspective.”
Endocrinologists have called for multidisciplinary management of cardiorenal metabolic (CRM) syndrome, saying it’s far more cost-effective than treating heart, kidney, and metabolic conditions as separate diseases.
Malaysia continues to struggle with a non-communicable disease (NCD) crisis, with many people suffering from multiple chronic conditions. About one in five adults are living with diabetes and more than half of the country’s adult population are either overweight or obese.
Perodua’s directive was issued to its panel clinics despite the Ministry of Health (MOH) repeatedly touting the importance of primary over tertiary care to prevent complications that often cost more to treat.
CodeBlue has requested comments from Perodua.
