With generic versions of the weight-loss drug Ozempic expected to hit the Canadian market this year, provincial data shows the number of times the medication has been dispensed from pharmacies across Manitoba has more than quadrupled over the past four years.
“I was really surprised about the numbers. Those are larger than I anticipated,” said Vernon Dolinsky, a diabetes researcher at the Children’s Hospital Research Institute of Manitoba.
Introduced in 2018, Ozempic is a brand name drug used for the treatment of Type 2 diabetes and as an anti-obesity medication.
The active ingredient in Ozempic is semaglutide — part of a class of drugs known as glucagon-like peptide-1 (GLP-1) agonists, which regulate blood sugar levels and appetite.
The number of Ozempic claims covered by Manitoba’s pharmacare program spiked from 17,644 during the 2021-22 fiscal year to 88,367 in 2024-25, according to provincial data.
“I would anticipate that as many of these medications come off patent that we’re going to see more people want to start taking them,” said Dolinsky.
- Do you use Ozempic or other weight-loss medication and want to share your story? Send your tips to [email protected].
The company that makes Ozempic, Novo Nordisk, also has two other brand name medications to treat Type 2 diabetes and obesity: Rybelsus and Wegovy.
As of this week, Novo Nordisk has lost its market exclusivity over semaglutide drugs on the Canadian market, opening the door to generic versions. Canada is the only country where the company allowed the patent for its semaglutide drugs to expire, paving the way for “regulatory exclusivity” to end as of Jan. 4.
“These medications work [for both diabetes and weight loss]. It’s very positive for people because it will improve their health,” said Dolinsky.
“On the other hand, we still don’t have a very good grasp on what the long-term effects of these medications are.”
Ozempic gained exception drug status under Manitoba’s pharmacare program in 2021, meaning it’s a medication recommended for coverage by the Manitoba Drug Standards and Therapeutics Committee.
For now, only people prescribed Ozempic for treatment of Type 2 diabetes are eligible to have the cost covered under pharmacare in Manitoba. The rest either pay out-of-pocket or rely on private insurance.
“I would suspect that there’s quite a few people who don’t rely on the provincial formulary to pay for their medications,” said Britt Kural, a pharmacy practice adviser with Pharmacists Manitoba.
“You have to have at least been tried on two other medications, in combination with diet and exercise, and not be able to reach your targets or your goals for your management of Type 2 diabetes before the province will pay for that medication,” said Kural.
Because Health Canada only recommends Ozempic be prescribed for patients with Type 2 diabetes, many insurance companies, such as Canada Life and Manulife, do not typically cover the cost if the medication is not prescribed specifically for that treatment.
Worth the cost, says Ozempic user
Fortunately for Winnipeg’s Hartley Macklin — who was pre-diabetic when he was prescribed weight loss medication — his private insurance covers about 80 per cent of the cost of the medication. He pays the remaining 20 per cent out of pocket.
He acknowledges the expense could be a barrier for many, but says for him, the benefits outweigh the costs.
“When you factor in the other costs of being obese — food, McDonald’s, Burger King, whatever — suddenly that cost [of Ozempic] becomes much lower,” said Macklin.
A month’s supply of Ozempic typically costs over $200. For Wegovy — the medication brand meant to manage weight loss specifically — it’s over $400.
Despite the high cost, Macklin isn’t surprised to hear more people are using it in Manitoba.
Since he began taking Ozempic in 2018, he’s lost between 70 and 80 pounds.
“That has a huge effect on your lifestyle and what you can do, and travel, and just driving somewhere,” said Macklin. “Cars are not built for 320-pound people.”
According to the Canadian Adult Obesity Clinical Practice Guideline, obesity is defined as a chronic disease.
Macklin says people living with obesity have a disconnect between the stomach and the brain — when the stomach is saying it’s full, the brain isn’t receiving the message. Ozempic, which suppresses appetite, helps address that, he said.
“Before Ozempic, everything looked great — it’s colourful, it’s popping, it’s wonderful, it’s hitting every light in my appetites,” he said.
“Now, there’s often times where I just look at the menu or look in my refrigerator, [and] can’t decide what I want to eat because I just don’t have an appetite.”
‘Rebound weight gain’ a concern: researcher
Kural says that while studies have found Ozempic can help with weight loss, people should consider whether it is right for them.
“I think the important thing to remember with Ozempic is that it’s not meant to be used just to lose weight for people who don’t have, you know, significant weight to lose,” said Kural.
Natalie Riediger, an associate professor in the department of food and nutritional sciences at the University of Manitoba, has been studying how the marketing for medications like Ozempic contributes to general pressures that people, particularly women, feel to lose weight.
“There’s been some strides, I’d say, in recent years about body acceptance or body positivity,” she said.
But “now we’ve kind of experienced a bit of a backslide, and that’s partially due to these medications and particularly the marketing surrounding them that do target weight loss.”
Another concern she has is around the notion of weight cycling, or “yo-yo dieting” — when people lose and regain significant amounts of weight in short periods of time.
Weight cycling has been associated with adverse health effects such as chronic inflammation, cardiovascular issues, blood glucose disorder and an increased risk of developing diabetes.
“We do know that with these medications like Ozempic that many people do not stay on them, and when they don’t stay on them, they tend to regain the weight that they lost,” Riediger said.
The most common reason people don’t stay on Ozempic for an extended period is because of the harsh side-effects, which often include nausea, vomiting, diarrhea and stomach pain, said Dolinsky.
Macklin said any side-effects he felt were very mild, but he’s heard from many people who have struggled with them.
However, Dolinsky’s main concern is the loss of muscle mass as people use medication for general weight loss.
“Essentially, if you lose muscle mass and you stop taking the medication, it’s much more likely that you’re going to put on a substantial amount more weight as a result,” resulting in a kind of “rebound weight gain,” Dolinsky said.
“Muscle is important for many other things,” particularly as people age, he said. “It maintains healthy bones as well, so it’s really important to maintain your muscle mass.”
Kural said anybody using Ozempic “should also be thinking about how they’re eating, how they’re exercising, and making sure they’re also keeping their strong muscle mass.”
Managing the side-effects of Ozempic and other drugs like it can be a process, she said.
“It can sometimes take weeks to months to identify what works best for you, what dose works best for you, and where the side-effects and tolerance of those side-effects land,” she said.
Macklin is hoping governments across Canada recognize the potential benefits to the health-care system from a reduction in obesity.
The U.S. Food and Drug Administration recently approved a pill form of Wegovy. The pill is under review from Health Canada.
Canadian governments “haven’t yet experienced the idea that there’s going to be less heart attacks and less problems, less falls, less everything else,” with increased use, said Macklin.
“They’ll save money over the long term if they can keep people a bit more fit.”
