As patents on weight-loss drugs expire, doctors and patients hotly anticipate cheaper generics

At Dr. David Macklin's weight management practice in Toronto, the name Ozempic is mentioned almost daily in appointments. But recently, another word is coming up just as often — generics.

"It is a regular conversation, daily in fact, where patients will be asking when their … medications may be less expensive," said Macklin, who is the director of the Medcan Weight Management Program.

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

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

But Novo Nordisk's patent expired in Canada in January, followed by a number of other countries including India just last week — paving the way for cheaper, generic versions. 

While it's not clear exactly when generic versions of these drugs will be available in Canada, patients and doctors are eagerly anticipating that moment, because it means the medications will become more cost effective and accessible to those who need them.

"It's an extremely exciting prospect that individuals living with this real disease have access to a remarkably safe and effective medication," said Macklin, referring to obesity and generics lowering the cost.

Macklin receives honoraria and consulting fees and serves on the national advisory boards for the manufacturers of Novo Nordisk and Eli Lilly, which makes Mounjaro, a different Type 2 diabetes drug also used for weight loss.

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

While Health Canada doesn't give any further timeline as to when drugs might be approved, Mina Tadrous, associate professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto, says he estimates generics might be available by this summer or early fall.

In India, a number of companies secured early approval for generics and started selling them the day the patents expired. One Indian company was offering generics for as little as $19 Cdn a month. Analysts expect around 50 generics could enter the Indian market within months.

Tadrous says that while India is a major supplier of pharmaceuticals and ingredients to Canada and often gets generics first, all of those drugs still have to go through Health Canada's approval process before they can be sold here. So it's unlikely generics approved there will have any short-term impact on Canada.

How much the generics will cost depends on a number of factors based on Canada's drug pricing framework, but Tadrous says once enough generics come online, it could be around $100 a month or less depending on the dosage — a substantial savings for Canadians.

"I think it'll be a big turning point," he said.