As patents on weight loss drugs expire, doctors and patients are hoping for cheaper generic drugs

At Dr. David Macklin’s weight management practice in Toronto, the name Ozempic is mentioned almost daily in appointments. But recently, another word is often coming up – generic.

“It’s a regular conversation, really, where patients will be asking when their … medications can become less expensive,” said Macklin, director of the MedCann Weight Management Program.

Novo Nordisk – the company behind the blockbuster diabetes and weight loss drugs Ozempic and Vegovy – for years held a patent on semaglutide, the active ingredient in drugs that mimics the hormone insulin and is used to treat diabetes and aid weight loss.

The cost of the patent was high because Novo Nordisk was the only company that could make the drugs. According to Macklin, a monthly supply of Ozempic or Vegovy costs between $300 and $400 — sometimes even more, depending on the dose.

But Novo Nordisk’s patent finished in canada in januaryAfter this many other countries are also included India Just last week – paving the way for cheaper, generic versions.

Although it is unclear when generic versions of these drugs will be available in Canada, patients and doctors are anxiously awaiting that moment, because it means the drugs will become more cost-effective and accessible to those who need them.

“It’s an extremely exciting prospect that individuals suffering from this real disease have access to a remarkably safe and effective drug,” Macklin said, referring to obesity and lowering the cost of generic drugs.

Macklin receives honorarium and consulting fees and serves on the national advisory board for Novo Nordisk and Eli Lilly, the makers of Monjaro, a different type 2 diabetes drug that is also used for weight loss.

Generics are already coming to India

Right now, Health Canada says there are nine generic semaglutide drugs under review for approval in Canada. The agency’s target timeline for initial review of a generic drug is 180 days, and it says submissions for generic semaglutide drugs are “on track to meet review targets”.

Although Health Canada has not given a timeline for when the drugs could be approved, Mina Tadrus, an associate professor in the Leslie Dann Faculty of Pharmacy at the University of Toronto, says she estimates generic drugs could be available by this summer or early autumn.

In India, many companies get early approval for generic drugs and start selling them the day the patent expires. an indian company Was offering generic medications for as low as $19 Cdn per month. analysts expect about 50 generics May enter the Indian market within a few months.

Tadrus says that while India is a major supplier of pharmaceuticals and content Generic drugs are available in Canada and often first, as all those drugs still have to go through the Health Canada approval process before they can be sold here. It is therefore unlikely that generic drugs approved there will have any short-term impact on Canada.

How much generic drugs cost depends on many factors. Canada’s drug pricing frameworkBut Tadrus says once enough generic drugs come online, it could cost about $100 a month or even less, depending on the dose — a huge savings for Canadians.

“I think this will be a big turning point,” he said.

Lower cost equals greater reach

Patients like Sarah Brooks are desperately waiting for generic drugs.

She first went on Ozempic in 2023 to help manage her weight and “food noise” – persistent food thoughts and cravings – in 2023. It also helped Brooks feel full after eating in a way she never did before.

But when Brooks lost her job at the end of 2024, she also lost her benefits and couldn’t afford the drug. When this happened, he regained the weight he had lost, a common occurrence for patients who stop taking semaglutide.

Brooks has been back on semaglutide for a year — she now uses Wegovi — because the benefits of her new job cover some of the cost. But she’ll have to use discretionary benefit money, because her plan doesn’t cover semaglutide like other prescriptions.

“Our benefits are allotted $2,000 a year for us, and I’ll spend all of that on (medications),” Brooks said.

He hopes generic drugs will come online soon, as his benefits will only cover a few more months of Wegovi. She thinks she might be able to pay out-of-pocket to take the medication for a while, but depending on other personal costs, she says she might consider skipping some doses.

“I hope it doesn’t come to that,” Brooks said. He also said that the drug “makes life easier.”

Nav Persaud, Canada Research Chair in Health Justice and a staff physician at St. Michael’s Hospital in Toronto, says cost is a major issue for his patients.

Even those who have insurance may have difficulty affording the co-payment because it is so expensive. Persaud says patients without coverage almost always have to reduce their dosages or stop taking medications altogether, often having to make difficult decisions about how to prioritize their prescriptions or necessities like groceries.

He says patients who have to come off medications are often frustrated with regaining weight.

“In that situation, most people regret taking the drug and wish they had never heard about it because they don’t have the money and their weight is the same or higher than when they started taking the drug.”

For this reason, doctors like Persaud, who treats obesity, are happy that generic drugs are finally on the way — though they say Canadians shouldn’t wait until patents expire to access life-changing drugs like GLP-1.

He says the federal government could have issued a compulsory license to allow any third party to make semaglutide drugs, so that Canadians could access the drugs at a more reasonable price before the patent came out.

Weight management Dr Macklin says improving access to generic medicines could also have social benefits, as obesity is still highly stigmatised.

He says it’s seen as “a disease of choice, where people are eating too much and not trying hard enough and they don’t have enough willpower.”

But when his patients see how much medications help if diet and exercise don’t work, he says they often realize the problem is a medical problem — not a personal failure.

“By expanding access, it can combat bias as more people have that ‘aha’ moment,” Macklin said.

They also hope that generic drugs, providing broader access to medical interventions, could reduce costs and burden on the health care system. Obesity Canada sets price for not treating obesity $27.6 billion annually.

Concerns about cosmetic use

As a family medicine practitioner and clinical researcher in Toronto, Dr. Iris Gorfinkel says GLP-1 medications are brought in every day, often by patients who don’t fit the criteria for their use.

Gorfinkel says that because of societal standards, female patients in particular seek the drug to help them lose 10 or 15 pounds for cosmetic reasons.

She says the introduction of generic drugs means that drugs will become more accessible not only to those who need them, but also “to individuals who are not technically approved.”

Gorfinkel also points out that medications are not always a simple solution. many patients die stop using them In the long run, further symptoms may include nausea, vomiting, diarrhea and stomach pain.

As interest in GLP-1 drugs for weight loss increases, sites allowing easy access have already emerged, indicating A warning from Health Canada About counterfeit or unauthorized versions earlier this year.

And in 2023 a Toronto Star investigation Documented how journalists accessed Ozempic for weight loss by entering incorrect height and weight through a for-profit telehealth website.

But Persaud says the spread of these online services is likely to be fueled in part by the high cost of drugs.

“I think, ironically, if drug prices were lower we would actually see less of it,” he said. “There will be less incentive to set up these systems to distribute these drugs.”