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Good morning. Wendy Cox in Vancouver this morning.

The scale is impressive: B.C. Health Minister Adrian Dix has outlined how Americans are using Canadian pharmacies to acquire cheaper versions of a drug that holds the promise of swift weight loss.

Thousands of U.S. residents received Ozempic prescriptions at fees of roughly $300 per month – rather than the U.S. going rate of up to $900 per month – by getting their prescriptions written by a Canadian doctor and filled via two B.C. pharmacies.

On Thursday, Nova Scotia’s College of Physicians suspended the doctor it alleges was the go-to for many of those Americans.

Dr. Gus Grant, registrar and chief executive officer of the College of Physicians and Surgeons of Nova Scotia, named Dr. David William Davison as the prescribing physician. The Nova Scotia college lists only one physician by that name and the college’s website lists his practice in Monahans, Tex. The statement said Dr. Davison lives in the U.S. but holds a Nova Scotian licence. Dr. Davison could not be reached for comment on Thursday.

According to the statement, the Nova Scotia college was alerted to the activity of one of its members by the College of Pharmacists of British Columbia.

In a letter to the Nova Scotia College of Physicians, the B.C. college noted two pharmacies in the province had received 7,500 prescriptions written for semaglutide in February, 5,800 in January and 3,860 in December. That is a total of 17,160 over three months.

It means that the prescribing physician would have had to write at least 267 prescriptions every day in February to get to 7,500. That’s a lot of forms to fill out.

“Based on volume alone, the prescribing is not in keeping with the standards of the profession,” Dr. Grant said in the statement Thursday.

“I cannot see how the volume of medications prescribed could possibly be supported by proper medical assessment and judgment. On its face, the prescribing appears incompetent.”

Pharmacists in Canada require the signature of a Canadian doctor to fill prescriptions for U.S. citizens.

As Justine Hunter reported this week, Mr. Dix discovered the pipeline of Ozempic from Canada to the U.S. late last year when he directed his staff to provide coverage for the drug under PharmaCare, the province’s publicly funded prescription program. The challenge, he learned, was that a significant amount of the province’s supply was being diverted to the U.S., raising concerns about availability.

Now that there is some clarity on who was issuing the prescriptions, there has yet to be much information on the B.C.-based pharmacies that filled them.

Pointedly, the statement from Dr. Grant notes: “Before any medication is dispensed, it is up to pharmacists to determine whether the prescription is appropriate.”

Justine writes that the College of Pharmacists of BC says it has inspected some pharmacies to determine whether they are compliant with its standards of practice related to online sales.

The standards require pharmacists to check prescriptions for completeness and appropriateness, to review the patient’s health information, and to consult with the patient concerning their drug history.

Online pharmacies such as Canada Drugs Direct encourage U.S. shoppers to take advantage of the benefits of a health care system that is not geared for profit.

Kate Hanna, spokesperson for Ozempic’s manufacturer Novo Nordisk, said the company and the B.C. government have a “shared interest” in ensuring the province’s supply.

“We will work with and support all governments in the efforts to limit the sale of Ozempic to non-Canadian residents. We’ve also engaged Health Canada on this issue in the hopes of identifying a national solution,” she said in a statement to The Canadian Press last week.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.

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