Wegovy Negotiations Fail, Leaving Canadians Without Coverage Options

Negotiations aimed at securing public health coverage for the weight-loss drug Wegovy in Canada have stalled. Danish pharmaceutical company Novo Nordisk, the manufacturer of Wegovy, declined to engage in talks to lower the medication’s cost, which stands at approximately $5,066 annually for patients. This development leaves many Canadians without affordable access to the treatment, despite recommendations from health authorities.

The pan-Canadian Pharmaceutical Alliance (pCPA), which negotiates drug prices on behalf of provincial, territorial, and federal governments, had been asked by Canada’s Drug Agency to initiate discussions with Novo Nordisk. However, according to the pCPA, these negotiations “concluded without agreement,” as Novo Nordisk did not present any offers. The agency confirmed that the file has now been closed, but remains open to future negotiations should the company reconsider.

Canada’s Drug Agency recently indicated that Wegovy could be eligible for public reimbursement under specific conditions, particularly for individuals with a body mass index (BMI) of 27 or greater who also have pre-existing cardiovascular conditions. These conditions may include issues related to narrowed arteries that affect blood flow. To qualify for coverage, patients would need to be on a reduced-calorie diet and engage in increased physical activity while also benefiting from a cost reduction for the drug.

Despite these recommendations, the agency noted that Wegovy, as priced, does not provide satisfactory value to the health-care system. An analysis suggested that public drug plans could face costs of up to $600 million over three years, potentially escalating to $3.5 billion depending on the uptake of the drug among Canadians.

Ian Patton, director of advocacy and public engagement at Obesity Canada, emphasized the importance of accessibility to effective weight-loss medications. He acknowledged that while drugs like Wegovy are not a cure-all, they can have significant benefits for those who respond well to them. Patton stated, “When we have instances like this where a negotiation is broken off, it just means that Canadians will not have improved access to those treatments for a longer period of time.”

The failure to reach an agreement for Wegovy’s coverage reflects ongoing challenges in ensuring access to obesity medications in Canada. While semaglutide medications, which include Wegovy, Ozempic, and Zepound, are approved for use under particular conditions, the lack of public reimbursement remains a significant barrier for many patients.

In the United States, similar medications have seen price reductions, notably through initiatives announced earlier this month by former President Donald Trump, aimed at making these treatments more affordable for qualifying patients under the Medicare and Medicaid programs.

As the situation stands, many Canadians are left without viable options for accessing Wegovy, and the future of negotiations remains uncertain. The hope for generic alternatives may provide some relief, but for now, the lack of public coverage for Wegovy underscores a critical gap in health care access related to obesity treatment in Canada.