Cheaper versions of medications to treat obesity, like Ozempic and Wegovy, could be on the market in Canada as soon as January.
Ozempic is a social media darling — with celebrities singing its praises and people posting about major weight loss. But a patient can pay $400 a month for such medications, says Dr. Sanjeev Sockalingam, Obesity Canada’s scientific director and a professor of psychiatry at the University of Toronto.
He says his patients have been frustrated and disappointed by the “prohibitive” cost.
But now, several companies say they intend to market cheaper versions of such drugs. Here’s what medical experts say:
What are these medications?
Injectable prescription drugs, sold as Ozempic and Wegovy, and the pill Rybelsus all contain the ingredient semaglutide. This class of medication, known as glucagon-like peptide-1 (GLP-1s), regulate blood sugar levels and appetite.
Health Canada previously approved Ozempic to treat diabetes and Wegovy for weight loss. Nearly 33 per cent of Canadians (10.6 million people) were obese in 2023, according to a recent study.
How much could the price come down?
Novo Nordisk, maker of Ozempic and Wegovy, will effectively lose its price protection on those drugs in Canada in January, opening the door to generic versions.
Mina Tadrous, an associate professor who evaluates pharmaceutical prices at the University of Toronto, says three or four companies have them in development or are starting the paperwork.
Tadrous says the number of companies affects pricing.
“The classic framework is that if you only have one, it comes down from the list price to 75 per cent,” Tadrous said. “If we have two, it goes down to 50 per cent and if we have three it hits 25 per cent.”
Three manufacturers could bring the price down to $100 from $400 for the same strength of semaglutide product, Tadrous estimates.
Have the generic medications been approved?
Not yet. Health Canada needs to consider each company’s application to make and sell generic versions of the injectable medication, known as a biosimilar.
Since they won’t require new clinical trials, they could be available within weeks of Health Canada’s approval — “grandfathered” in, based on the original trials, says Sockalingam.
“It’s really about the equivalency of the medication in terms of its availability in the body and its metabolism.”
Will insurance cover them?
Semaglutide is already listed on the Ontario drug formulary — a list of publicly covered medications for those over age 65, people living in long-term care homes, and for people receiving Ontario Works or disability payments.
That means as soon as a generic form is available, those on public drug insurance plans could switch to it, and private insurance plans like those offered by employers likely will do the same, Tadrous says.
Dr. Kaberi Dasgupta, a professor of medicine at McGill University and a researcher, says this would be good news for people who have excess weight and resulting complications but who can’t currently afford the branded medications.
Generic versions will “open the door for many more people,” Dasgupta said.
What’s involved in taking these medications?
Dasgupta says it’s important for people taking semaglutide to have it prescribed by a physician and then monitored.
“We should be insisting on having publicly accessible good diet and physical activity supports because we live in a society where people are gaining more and more weight,” Dasgupta said.
In England, for example, semaglutide is recommended with at least 13 hours of counselling on diet and physical activity.
What about drug shortages?
Because some medications also treat Type 2 diabetes, doctors and health-care policy experts continue to watch supply chains to prevent shortages.
Dr. Harpreet Bajaj, an endocrinologist with LMC Healthcare in Brampton, Ont., recalls many times when patients with diabetes had to go off Ozempic or other GLP-1 medications because none was available.
“Having a biosimilar, which is made by an entirely new pharmaceutical company and maybe … made in a more cost-effective way would also relieve some pressures on any future shortages that we might expect,” Bajaj said.
Dasgupta, who also treats diabetes, said in her experience in Quebec, sometimes the medication is more accessible through the province’s publicly funded plan for those who fulfil the medical criteria than through some private insurers that focus more strongly on cost.
