Ontario limits access to Ozempic to conserve supply for people with diabetes

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Ontario government takes steps to restrict access to Ozempic and conserve supply for people with type 2 diabetes under provincially funded program amid shortages driven by popular demand for this medication intended for weight loss.

Starting Wednesday, people who do not have type 2 diabetes will no longer have coverage for this drug under the Ontario Drug Benefit (ODB), according to the Ministry of Health.

“This action was taken to conserve supply for those who need Ozempic the most and aligns Ontario with many other provinces who have taken action to protect their supply,” the spokesperson said on Wednesday. Ministry of Health, Hannah Jensen, in a statement to CBC News.

Ozempic, one of several brand names for a drug called semaglutide, is a weekly injection that helps lower blood sugar levels by helping the pancreas create more insulin, and belongs to a class of drugs known as glucagon-like peptide1, or GLP1.

Currently, ODB and OHIP+ cover most of the cost of approximately 5,000 prescription drugs for everyone over age 65, or for people age 24 or younger who are not covered by a private insurance plan, people living in long-term care homes, as well as for people who receive funding from Ontario Works, the Ontario Disability Support Program or who are registered to the Trillium Drug Program.

The ministry said moving Ozempic from the general benefit category to limited use under its program means any patient seeking a prescription for the drug must meet clinical criteria.

This change, which aims to help pharmacies and patients facing shortages of Ozempic and similar drugs, is necessary at this time, said Sanjeev Sockalingam, scientific director of Obesity Canada and professor of psychiatry at the University of Toronto. But the department should also reconsider limitations on people with obesity, Sockalingam said.

“I understand the government’s response is to limit treatment to eligible people with type 2 diabetes,” Sockalingam said.

“I think this decision really speaks to the shortages of Ozempic or semaglutide more generally in the system and in this class of drugs that are used both for diabetes, but also for people with obesity.”

WATCH | Ontario limits access to Ozempic:

How growing demand for Ozempic is forcing Ontario to limit coverage for some users

Ontario is restricting access to Ozempic and retaining supplies for people with type 2 diabetes because the drug continues to be prescribed for weight loss. CBC’s Patrick Swadden spoke to users and doctors about the change.

Patients in the program who will no longer qualify for the drug under the new “limited use” criteria will have to pay out-of-pocket for the drug if it is intended for weight loss. Sockalingam says that means between $450 and $500 a month.

Ontario woman ‘felt robbed’ during shortage

Lynda Williston, a resident of Whitby, Ontario, uses Ozempic to treat type 2 diabetes. She said the drug was a significant help in keeping her blood sugar levels under control until the shortage hit and she could no longer get their hands on the vaccine last year.

“Unfortunately, when there was a shortage, I had to be removed and that’s when I realized how much it had helped me,” Williston said.

Williston said he was prescribed a similar medication, but it was not as strong. When Ozempic was back in stock in pharmacies, she took the drug again and noticed a big difference.

“It was very upsetting because I knew some people were taking it for their weight issues and while it was wonderful for them, it was taking me off the medication and that was very upsetting and very upsetting,” Williston told CBC News.

“I felt robbed because I knew it was something that helped me medically. And I just thought it would be like if someone came up to you and took away your crutches and then said, ‘Yeah, you can walk, you’re still fine’,’ but you’re not.”

Medication should be considered for obesity: healthcare professionals

Kyro Maseh, pharmacist and owner of Lawlor Pharmasave in Toronto, said his pharmacy, like every other pharmacy in the province, has experienced shortages of Ozempic over the past six months.

“It is important to allocate drugs to diabetic patients. But in the future, I think it should also be considered for obese patients,” Maseh said on Wednesday.

“Obesity represents a very heavy social and health burden and leads to numerous health costs.”

Maseh said he has seen first-hand the positive results some patients have achieved after losing weight using the drug.

“It may be anecdotal from my perspective, but it’s definitely worth looking at from a provincial perspective and looking at the impact that lowering obesity rates would have on the overall cost health care,” he said.

A man smiles at the camera
Sanjeev Sockalingam, scientific director of Obesity Canada, said obesity must be recognized as a chronic and complex medical condition similar to diabetes and other chronic diseases. (Obesity Canada)

Sockalingam agrees with this view, saying obesity needs to be recognized as a chronic, complex disease similar to diabetes and other chronic illnesses.

“It’s important for us to look more broadly at the policy level, whether it’s provincial government forms as well as health insurance and private health insurance,” he said.

“We have treatments available and we need to think about how we value these treatments alongside other health conditions to ensure they are accessible. It’s not just this drug, but all available drugs that are now approved and indicated for treatment. “We really need to think about how to get this to the patients who need it most.”

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