Individuals who cannot afford private weight-loss treatments are likely to face heightened risks of developing obesity and its associated complications, according to experts. Recent changes in Ontario regarding the listing of Ozempic under the Ontario Drug Benefit Program have sparked concerns among specialists. Experts suggest that the decision to restrict Ozempic access for individuals on social assistance may be primarily driven by cost-cutting motives rather than concerns about supply shortage.
The amendment in the listing status of Ozempic aims to preserve the supply of this medication for individuals with type 2 diabetes, given ongoing supply challenges. However, the consequence is that individuals reliant on Ontario’s public drug program, including seniors, will now need to bear the expense of Ozempic for weight loss themselves.
Experts acknowledge the importance of ensuring access to Ozempic for those with type 2 diabetes. Nonetheless, they caution that withdrawing coverage could have detrimental long-term health implications for individuals with obesity who can no longer afford the medication. This move also raises concerns about equitable access to weight-loss treatments across the province.
Dr. Sanjeev Sockalingam, scientific director for Obesity Canada and professor at the University of Toronto’s Faculty of Medicine, highlights the potential inequities caused by limiting access to treatment. He emphasizes that individuals unable to afford private weight-loss services are particularly vulnerable to obesity and its associated health risks.
Jennifer Lake, an assistant professor at the University of Toronto’s Leslie Dan Faculty of Pharmacy, suggests that while ensuring access to medications for patients with type 2 diabetes is crucial, the province’s decision may not necessarily address supply issues. She indicates that pharmaceutical supply and distribution are largely controlled by corporations rather than the government.
The change in the listing status of Ozempic, now requires patients to meet specific clinical criteria to receive coverage. While adult patients with type 2 diabetes will still be eligible for coverage, those previously covered for Ozempic for weight loss will no longer have access.
The out-of-pocket cost for Ozempic for weight loss could reach up to $500 per month, according to Jen Belcher, vice-president of strategic initiatives and member relations for the Ontario Pharmacists Association. Despite inquiries, the Ministry of Health has not disclosed the number of individuals affected by the change or any increase in demand for Ozempic prescriptions.
Eligible individuals for public drug coverage include seniors, youth under 24 through OHIP+, and those enrolled in programs such as the Ontario Disability Support Program, Ontario Works, and the Trillium Drug Program.
Research suggests that implementing limited-use codes on drugs can help reduce costs for governments and insurance companies. However, there are concerns about individuals seeking more healthcare services when they lose access to their preferred medication.
While Health Canada approved semaglutide, marketed as Ozempic for type 2 diabetes, for weight loss under the brand name Wegovy in 2021, Novo Nordisk did not make it available in Canada initially. However, Novo Nordisk Canada confirmed that Wegovy would be available to Canadians soon, citing high global demand for the medication.
Dr. Sockalingam emphasizes the importance of semaglutide for individuals living with obesity, particularly those with serious health issues and a diminished quality of life due to excess weight. He expresses concern that individuals with obesity already face barriers to healthcare access and that this recent decision will exacerbate these challenges further.
