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Wegovy approved in Canada for weight-loss!

Wegovy approved in Canada for weight-loss!

 

Health Canada finally came through. Wegovy was officially approved for obesity management in Canada on November 25, 2021! I honestly was not sure it would happen before the New Year. We were coming down to the wire with only 5 days left in November, and God knows EVERYONE checks out for the remainder of the year starting on December 1st. Especially government employees. Thankfully they had a few A-type individuals reviewing the application who did not want to return to a stack of applications in January!

 

Woohoo! Where can I get? 

While Wegovy is approved, it, unfortunately, will not be commercially available until sometime in the Fall of 2022. Usually, there is a slight delay between approval and medication availability, but the delay is a bit longer in this situation. Now Novo Nordisk, or Novo, as we will from here on in, as Nordisk is auto correcting to ‘Nordick,’ did not state a reason for the long delay. Since they have already had some supply problems in the US combined with the current general supply chain issues globally, I suspect they want to ensure they have a good amount of stock in place. So I think it’s safe to assume that Wegovy will probably start getting prescribed like hotcakes once it hits the pharmacy shelves.

As an aside, in case some of you are judging me regarding the auto-correction above. I don’t know what that kind of auto-correction says about me or google docs for that matter. The funny thing is that my cell phone will forever autocorrect to ‘ducking’, but ‘Nordick’ is a non-issue? It probably is an actual word with a definition, but I will never know as I have no plans to roll the dice with google…

 

Moving along…

Right. Here is a brief refresher if you haven’t read my previous blogs on Ozempic here, here, here, here AND here

Wegovy is Ozempic or semaglutide, the name of the actual drug in both medications. However, Wegovy has the indication for Obesity and is dosed to 2.4mg once weekly, and Ozempic only has the indication for Diabetes and is dosed to 1mg once weekly. 

They’re exactly the same drug and molecule, just different names and dosages. 

 

What’s the deal? Why same same but not different? 

 

The drug company could have submitted their application to Health Canada again under the name Ozempic at a higher dose, BUT changing the name allows them to extend their patent on the drug so generic drug companies can’t release a near-identical product at a cheaper price. 

Therefore, said drug company can continue making a healthy profit for a few extra years. Now you might be thinking we should actually call them ‘Novo Nordicks’, but they aren’t the ones to blame – they are simply using the system that’s in place to their advantage to fulfill their duty as a for-profit company that serves the interest of their shareholders. The better option is to blame your government and also invest in Novo! 

Ok. I will step off my soapbox now to talk about the STEP trials! Ha that worked out quite nicely. 

So, the STEP trials were the landmark trials that were completed to prove the efficacy of Wegovy in obesity. In the STEP 3 trial, participants were provided with Wegovy at 2.4mg once weekly or a placebo and monitored over a 68-week period. The individuals on Wegovy lost on average ~16% of their baseline body weight compared to the placebo. AND almost 1/3 of the individuals lost ~20% of their baseline weight. Like holy ‘ducking’ Batman! These are the kind of results we see in bariatric surgeries, not with medications. As (another) aside, this could very well be the beginning of the end for bariatric surgery.

 

Amazing! But what will that do to cost for the user?  

A great and the most common question I have been receiving. How much will it be in Canada?! 

As of right now, Ozempic at 1mg once weekly costs ~$230/month. Increasing to the 2.4mg once weekly dose of Wegovy, it would be safe to assume the cost will be ~$400+/month. I am wagering about $430/month, similar to Saxenda, the only other GLP-1 medication indicated for Obesity management in Canada. Guess what? Saxenda just so happens to be made by Novo too, so they will likely match prices vs. outpricing their own drug, at least until the patent expires on Saxenda. Like I said, go invest in Novo. 

So no doubt the drug will be expensive, but this delay in availability may be a good thing in terms of insurance. It will give Novo more time to negotiate, pay off, etc., the various insurance providers to get Wegovy listed on their formularies for Obesity management. The public payers will likely still be a year behind that regardless, but they will get there. It will be hard for them to deny it as the medication is so effective in weight management. 

I want to mention one final thing and step back up onto my soapbox here. 

 

Ok, go for it. What else do I need to know about Ozempic? 

Right now, Ozempic comes as a reusable pen that you can obtain multiple doses from and can slowly adjust the dose based on clicks of the pen. This is amazing because Ozempic is potent AF, and some people need to titrate or increase the dose more slowly to avoid side effects. 

Wegovy, on the other hand, will not be in a reusable pen. It will be a ‘one-shot and done’ situation. This might be a good thing from a user error perspective, but they have now taken away the ability to customize a patient’s dosing; the pen you get is the dose you get. Unfortunately, that means a few people will have a bad time. I suspect there will be a lot of clinicians, including myself, still using Ozempic until a patient reaches a tolerable dose and then switching them over to Wegovy. 

Finally, with the extra pens and plastic one must think about the environment. Hopefully, Novo will be looking into some kind of recycling solution! These are just a couple of my critiques; no hard feelings, Novo! 

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That is all for now, folks. Wegovy will be in Canada soon, and this is just the beginning. As we speak, other agents in the pipeline are showing insane results from an obesity perspective. So stay tuned and stay safe! 

Until next time! Remember small tweaks lead to massive peaks! 

Dr. Dan

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