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Much like the United States, Canada has started to only cover Ozempic (semaglutide) for Type 2 diabetes treatment and no longer for weight loss. Insurers such as Canada Life have recently changed their policies on drug claims with Wegovy, Ozempic, and other semaglutide brands to only cover the costs of these drugs in the case of Type 2 diabetes treatment.
However, Canada Life, B.C PharmCare, and Ontario Health Insurance Plan (OHIP) are all insurers that cover either part or the full costs of your Ozempic treatment plan as part of your diagnosed Type 2 diabetes treatment.
Key Takeaways
Ozempic and Wegovy (both GLP-1 semaglutide injections) are either fully or partially covered by Canada Life, B.C. PharmCare, and Ontario Health Insurance Plan.
Much like in the United States, all GLP-1 semaglutide treatments are only being prescribed to those who have been diagnosed with Type 2 diabetes and no longer being prescribed for those who are seeking a weight loss treatment.
Which Insurers Cover Ozempic in Canada?
Rules and regulations around Ozempic (semaglutide) and Wegovy treatment are changing rapidly. Most recently, as of June 4th, 2024, Health Canada was attempting to keep up with the demand for the drug. Stating in a brief, “Novo Nordisk has also recently launched Wegovy (semaglutide). Wegovy is indicated for chronic weight management. Eli Lilly has advised Health Canada that, depending on the strength of the dosage, it expects shortages to be resolved by the end of 2024. While Eli Lilly continues to receive additional supplies, products may not always be available at pharmacies. Both companies are making efforts to increase manufacturing capacity to be able to meet demand.“
This comes at a time when the demand for Ozempic and Wegovy is at an all-time high in the United States. With a most recent KFF survey finding that nearly 6% of adult Americans in the United States are on a GLP-1 drug similar to Ozempic.
Insurers that are covering either part or the complete cost of the drug include:
Canada Life: Form for submitting your drug claim.
B.C. PharmCare: Form for submitting your drug claim.
Ontario Health Insurance Plan: Information about coverage.
In most cases, insurers in Canada are following very similar restrictions as to that in the United States, meaning that no patient will be treated with any type of GLP-1 injection of semaglutide if they are not being treated for Type 2 diabetes.
Those who are looking for weight loss treatment will not be prescribed Wegovy, Ozempic, or any other type of GLP-1 injection.
How Much Ozempic Costs in Canada
Ozempic can cost anywhere from $300CAD to $950CAD per pen. A pen is considered to either be a two-week or monthly-long treatment according to the treatment plan. Insurers are either providing a discount on each pen purchase or providing near-complete coverage for the pen purchase.
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Sources
Government of Canada. (n.d.). Ozempic (semaglutide): Supply notices. Health Canada. Retrieved September 4, 2024, from https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-shortages/information-consumers/supply-notices/ozempic.html
Kaiser Family Foundation. (2024, May 22). KFF health tracking poll – May 2024: The public's use and views of GLP-1 drugs. https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-may-2024-the-publics-use-and-views-of-glp-1-drugs/
Canada Life. (n.d.). GLP-1 receptor agonists: Prior authorization request form. https://www.canadalife.com/content/dam/canadalife/documents/forms/you-and-your-family/1-0-employer/1-3-request-an-assessment/1-3-2-prior-auth-drugs/en/glp1-m6453.pdf
Government of British Columbia. (n.d.). PharmaCare drug decision summary: Semaglutide (Ozempic). https://www2.gov.bc.ca/assets/gov/health/health-drug-coverage/pharmacare/decisions/semaglutide_ozempic_dds.pdf
Viva Health Pharmacy. (2023, September 1). Understanding Ozempic coverage by OHIP for weight loss: What you need to know. https://www.vivahealthpharmacy.com/understanding-ozempic-coverage-by-ohip-for-weight-loss-what-you-need-to-know/
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