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High demand in the United States for a new weight-loss medication has indefinitely delayed its arrival in Canada, prompting many Canadians to seek prescriptions for an almost identical drug that has been approved for the treatment of Type 2 diabetes.

An analysis by the Canadian Agency for Drugs and Technologies in Health (CADTH) and obtained by The Globe and Mail found that, in some provinces, 36 per cent to 74 per cent of non-public drug plan claims for Ozempic (prescriptions paid for through private or federal drug plans or out of pocket) were from people who likely did not have Type 2 diabetes, indicating the medication was likely being used for weight loss – an example of what is known as off-label use.

CADTH is an independent organization that advises governments on matters related to drug policy.

The CADTH study, published Thursday, was prompted by the soaring demand for Ozempic and rapidly escalating costs for drug plans across the country. Spending on Ozempic in Canada increased from $13.5-million in 2019 to $227-million in 2021, according to the study.

Danish multinational Novo Nordisk manufactures Ozempic but also produces Wegovy, the same medication in a different dose that is specifically marketed for the treatment of obesity. Wegovy was approved by Health Canada last November, but “unprecedented demand” in the U.S., where it launched last year, has led to shortages, Novo Nordisk spokesperson Kate Hanna said in an e-mail.

It’s unclear when it will arrive in Canada.

Ozempic and Wegovy are the brand names of semaglutide, an injectable drug that helps lower blood glucose levels. It has also been shown to help individuals lose weight when combined with exercise and a modified diet.

Soaring demand for Ozempic has also led to shortages in some countries, but Ms. Hanna said Canada has so far not been affected.

Brent Fraser, the vice-president of pharmaceutical reviews with CADTH, said “it just creates a number of different issues” when a drug is so commonly used for a non-intended purpose, as is the case with Ozempic.

In addition to concerns about drug safety, higher-than-expected costs linked to such medications could lead plans to place new restrictions on them, limiting access to such drugs.

For now, the demand for Ozempic as a weight-loss medication doesn’t appear to be slowing down, and experts say that’s unlikely to change as long as Wegovy remains unavailable.

According to the CADTH study, one in five people in Ontario taking the drug likely do not have Type 2 diabetes, which includes 15 per cent of Ozempic claimants on the provincial drug plan.

CADTH experts analyzed drug-claim data from across the country to determine which individuals taking Ozempic likely do not have diabetes. The researchers determined that people who had never submitted a claim for a diabetes drug or glucose monitoring device were likely taking Ozempic for weight loss rather than diabetes management.

The study says the drug’s popularity has likely been fuelled by direct-to-consumer advertising. Such ads are not legal in Canada and the study notes that Health Canada received six complaints regarding such ads for Ozempic from 2014 to 2021. The drug is also commonly featured on social media, with many users posting about their weight-loss experiences.

CADTH will also soon release its long-awaited decision on whether Wegovy should be covered by provincial drug plans. In the past, CADTH has not recommended reimbursement for drugs specifically designed for weight management.

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