Ozempic. Who is on it?

[getbak]

Originally Posted by photon

I think Blue Cross you need to show that certain other drugs didn't work and get a special authorization, but not 100% sure on that.

Yes, that's true... or it is with the Blue Cross coverage I have from work. I'm hoping they'll cover it in the new year when the generics come out.

[PaperBagger'14]

Originally Posted by SportsJunky

I know someone on mounjaro. Paying $850/month

Jesus, well if the drugs don’t work the starvation will

[JohnnyBeGood]

Diabetes is a major industry, that's for sure...

[Fuzz]

It's worth checking with your pharmacist to get an estimate by using the Innovacares card. It's free, and covers some of the costs. Looks to cover Ozempic and Wegovy.

https://www.innovicares.ca/en/

I'm not sure all that many people know this thing exists, but it's worth getting and putting on your pharmacy insurance file, as it covers some costs of several medications.


https://www.rxhelp.ca


is another one.

[Titan2]

Originally Posted by Fuzz

It's worth checking with your pharmacist to get an estimate by using the Innovacares card. It's free, and covers some of the costs. Looks to cover Ozempic and Wegovy.

https://www.innovicares.ca/en/

I'm not sure all that many people know this thing exists, but it's worth getting and putting on your pharmacy insurance file, as it covers some costs of several medications.


https://www.rxhelp.ca


is another one.

Actually, a big thanks for that. I know it applies to at least two of what I am on. Evan, a small amount monthly adds up.

[vegasbound]

I know the patent runs out in January in Canada but any idea when the generics actually hit the market and reduce the price?

[afc wimbledon]

Originally Posted by vegasbound

I know the patent runs out in January in Canada but any idea when the generics actually hit the market and reduce the price?

My guess is January, it's not just the Canadian market, there will be a shed load of yanks coming up to get them as well, the patent only expires in Canada

[Mccree]

Originally Posted by afc wimbledon

My guess is January, it's not just the Canadian market, there will be a shed load of yanks coming up to get them as well, the patent only expires in Canada

A few articles I have read seem to think June of 2026

[GioforPM]

Originally Posted by fotze2

What's people experience with drug plan covering it. Like viagra not a chance level? How much is it?

Mine did and then didn't (except for diabtics). I'm not on it myself but I know people who are and it worked fine. I thinkit should be covered under a plan if it is doctor recommdended and reduces other weight associated risks.

[Street Pharmacist]

Some info

1) Still no signals of any serious issues for the most part. One of the safest drugs we have. Nausea, constipation/diarrhea seen to be it for the most part. I know some are worried about long term side effects but that's not really how adverse effects generally work. The risk of serious side effects from a medication might increase with time, but if you didn't see any hint of it after hundreds of millions of doses consumed, it isn't like something will magically be seen later

2) Not really a "blood sugar" drug in the normal sense, as it really seems to be more a psychiatric medication in some ways. Some studies show very good potential for all types of addictions. Most of my patients remark how they didn't look at their phone much anymore, drink less coffee, smoke less cigarettes, drink less alcohol, etc.

3) because of the cost, most drug plans require a special authorization for glp-1 agonists. The criteria is usually being diabetic and tried metformin first. At the beginning, many plans did not require this but costs ballooned once everyone was on it

4) Cost wise, here's some help. For ozempic/wegovy, the cost of the pen is the same regardless of dose, so it's always much cheaper to go with a higher dose pen and "count clicks" when dosing to get the lower dose. You can do the same with mounjaro. Despite the fact the higher dose pens are more expensive, it's still cheaper overall to "count clicks". Mounjaro has a discount card you can get at their website that takes a fair amount off that goes up to $300-400 off the highest dose pen

5) As for biosimilars (not technically generics as these products are grown, not chemically manufactured), it's a bit complicated. In order to sell a biosimilar/generic you need an approval from Health Canada by doing studies showing it reaches the same blood levels or other markers of equivalence. These approvals are not necessarily quick. The patent expires January 4th, but only the people doing the approvals can really tell you when the biosimilars will be approved. I'd expect second quarter next year some time. As for cost, I would expect a massive drop in price. When provinces got together to negotiate with generic companies in the 2010's they came up with a non binding framework where pricing is 75% of reference if only one vendor has a generic on the market, 50% for 2, and 25-35% for 3 or more. Sandoz is on the record saying they expect to price theirs at ~30% of the reference. Because demand will be so high and price visibility will be crazy high, I would expect it'll end up going quite a bit lower than that. Manufacturing costs are estimated at less than $60 USD for a whole year's supply so there's lots of margin to play with for the manufacturers




I do expect to see a real shift in how these meds are offered to patients outside of normal channels. You can't advertise prices on medications, but you could offer "weight management services" that include medications and you'll see a big pressure on price.



Edit: oh, I forgot to add. Evidence is abundantly clear that the mean weight goes right back to pre-intervention weight within 6-12 months of discontinuing. This is a weight disorder treatment, not a cure

[Street Pharmacist]

Originally Posted by Fuzz

It's worth checking with your pharmacist to get an estimate by using the Innovacares card. It's free, and covers some of the costs. Looks to cover Ozempic and Wegovy.

https://www.innovicares.ca/en/

I'm not sure all that many people know this thing exists, but it's worth getting and putting on your pharmacy insurance file, as it covers some costs of several medications.


https://www.rxhelp.ca


is another one.

Innovicares covers I think $5 on ozempic and $15 on wegovy.

Mounjaro has a "my mounjaro" card you can get that covers hundreds.

These cards are a way for brand name products to keep some market share without really lowering their prices for those who have insurance that will pay

[Titan2]

Originally Posted by Street Pharmacist

...

4) Cost wise, here's some help. For ozempic/wegovy, the cost of the pen is the same regardless of dose, so it's always much cheaper to go with a higher dose pen and "count clicks" when dosing to get the lower dose. ...

Ok, I have a question. I went to 1.5 mg Oz and the pharmacy filled it as a 1mg pen and a .25-.5 pen and charged me for both pens. Was that the right way to do it? This makes me a bit more upset if I could have gotten a 2 mg and counted clicks. Should I complain? Thanks.

[Street Pharmacist]

Originally Posted by Titan2

Ok, I have a question. I went to 1.5 mg Oz and the pharmacy filled it as a 1mg pen and a .25-.5 pen and charged me for both pens. Was that the right way to do it? This makes me a bit more upset if I could have gotten a 2 mg and counted clicks. Should I complain? Thanks.

There is no 2mg pen. Ozempic was approved for diabetes and the target dose is 1mg. If going above 1mg it is probably cheaper to get 2x1mg pens because the 1mg pen has a total of 4mg in it whereas the .25-.5mg pen only has 2mg in it. Once above 1.5mg you're cheaper to go with wegovy which has pens up to 2.4mg (each pen has 4 doses in it). It's actually a complicated decision.

Essentially, a 1mg pen and a 0.5mg pen will have 6mg be exactly a 28 day supply as the doctor has likely written. If you get 2x1mg pens you now have a 5 week supply plus 0.5mg left in a pen. Both instances you've paid for 2 pens. Wegovy is more expensive than ozempic (exact same molecule), but with a 1.7mg pen you would only buy 1 pen. I'd call them and get a quote for next time as they may need you to get a different prescription from your dr if you wanted to change.


As for complaining, this is all "off label". Some pharmacists and doctors get upset if you recommend click counting because that increases the risk of dosing errors, plus many patients just want what the doctor ordered. I try to have a conversation with the patient so they know all the options but I don't think all pharmacies have done all the math and it's technically not what the manufacturer suggests or what the doctor technically ordered.

[Titan2]

I appreciate the detailed response. I hear you say that Oz and Wegovy are effectively the same thing?

[Street Pharmacist]

Originally Posted by Titan2

I appreciate the detailed response. I hear you say that Oz and Wegovy are effectively the same thing?

Yes. They're both Semaglutide, both made by Novo Nordisk. They just have different indications.