NEWS FLASH: This article has been updated from the original, which had been written before Health Canada approved the first generic for Wegovy.
Health Canada approved the first generic version of Wegovy, the weight-loss drug, on June 30. Marketed under the brand name of Sevmia, manufacturer Apotex has not yet published details on pricing. Six more generics are under regulatory review, with decisions expected in the coming months.
While it will take time for the products to reach pharmacies’ shelves and for insurers to put measures such as prior authorization in place to ensure appropriate utilization, plan sponsors may see savings by the end of the year.
Or will they?
The answer is complicated because the expected upsurge in demand for the medication, now that lower-priced generics are available, may significantly outpace the advantage of their lower price point. And plan sponsors that have held off on adding weight-management drugs to their plan, traditionally a standard exclusion, will be hard-pressed to continue to do so in face of the demand.
“Growth in adoption has been steady these last few years and many plans today provide some level of coverage, typically introduced with programs like prior authorization in place,” says Vicky Lee, Director, Pharmacy Consulting & Professional Services, Payor Solutions, TELUS Health.
“Coverage is increasingly a factor of attraction and retention as it is a reflection of the positive health outcomes resulting from sustained weight loss,” Lee adds.
Barbara Martinez, National Practice Leader, Drug Solutions, Canada Life, agrees that the genericization of Wegovy may represent a tipping point in terms of coverage of the category by private plans. “Historically plans have taken a blunt include/exclude approach to areas such as fertility, obesity, smoking cessation, erectile dysfunction or vaccines,” she explains. “These are old labels—sorting drugs into broad lifestyle categories has outlived its usefulness. Not only can it be discriminatory but modern drugs treat multiple conditions which makes disease-based labels impractical. We need a different framework.”
The main ingredient of Wegovy is semaglutide, which is also the main ingredient for Ozempic, used to treat type 2 diabetes. The two semaglutide drugs currently lead the pack in a class of drugs referred to as GLP-1s (glucagon-like peptide-1s). The first two generics for Ozempic became available earlier this year. Utilization of another duo of GLP-1s, Mounjaro (diabetes) and Zepbound (weight management), is also on the rise; however, generics will likely not be available before 2036.
Long story short, fuelled by positive outcomes widely reported in clinical studies and by mainstream media, GLP-1s are expected to have a significant impact on drug plans over the next few years. However, the age-old question remains, can plan sponsors afford them?
“They are medium-cost drugs that are very high volume,” says Martinez. “Most plans really won’t be able to afford to cover these drugs broadly. Plan sponsors have to be strategic, working with their benefits advisor and insurance provider, to balance affordability with access to coverage.”
Generic substitution, managed formularies, prior authorization, co-insurance levels and wellness programs are among the levers that plan sponsors can pull. Take 5 for Wellness shares eight additional must-know facts from Martinez and Lee to help inform your strategy.
1 – The numbers don’t lie
Wegovy ranked seventh in Canada Life’s block of business in 2025, up from 35th in 2024. For the total weight-management category, TELUS Health reports a ranking of 11th among all categories in 2025 based on eligible amounts submitted to private plans, up from 17th in 2024.
Two-thirds of Canadian adults are classified as having obesity (30 per cent) or are overweight (36 per cent), according to the most recent data from Statistics Canada. By comparison, between 25 and 30 per cent of Canadian adults have hypertension or high cholesterol.
2 – Pricing: TBD, not TPF?
Pricing for generic versions of Ozempic is straightforward since these drugs for type 2 diabetes fall under the purview of the pan-Canadian Pharmaceutical Alliance’s Tiered Pricing Framework (TPF) for generic drugs. It states that when there are three or more generics for an injectable drug, as will be the case here, the generics must be priced at 35 per cent of the brand-name drug (or lower, if the manufacturers so choose).
For Ozempic, with an annual treatment cost of between $1,300 and $4,100 depending on the dosage, according to TELUS Health, this translates into $850 and $2,700 annually for a generic (about $70 to $225 per month).
However, the TPF will not determine the pricing of generics for Wegovy, at least not at this point. That’s because the brand-name drugs must be covered by public plans for the TPF to kick in for generic pricing. Since public plans do not currently cover Wegovy for weight management, the TPF does not apply. As a result, the manufacturers of generic drugs for weight loss will set the price, not the TPF.
That said, industry analysts expect that once generics become available, public pressure will force governments’ hands to provide coverage for both the brand-name and generic versions. If that happens, the TPF will apply to generic weight-management drugs.
The current annual treatment cost for Wegovy is between $5,300 and $5,600 annually, reports TELUS Health.
3 – Brand name saving
Novo Nordisk, manufacturer of Ozempic and Wegovy, and Eli Lilly, manufacturer of Mounjaro and Zepbound, offer direct-to-consumer savings programs. “The goal is to prevent switching to generics by covering out-of-pocket costs. People may switch to brand-name drugs like Zepbound, which is not going to have generics for many years to come, and that could erode some of the generic opportunities for drug plans,” says Martinez.
4 – Key demographics
Three out of four claimants (76 per cent) taking a GLP-1 for weight management identify as female, according to Canada Life claims data for 2025. The average age of a claimant is 49 years (compared to 57 years for GLP-1 claimants for diabetes).
5 – For the long haul
More than three out five GLP-1 claimants (63 per cent), whether for weight loss or diabetes, also made a claim in 2025, up from 47 per cent a year ago. “The fact that 63 per cent of people taking them now have been doing so for more than a year speaks to the improvement in adherence. These members really want them, and they are being adherent,” says Martinez.
6 – What’s coming for weight loss
The U.S. Food and Drug Administration approved a pill format of Wegovy (currently administered by self-injection) in December 2025. It’s expected that Health Canada will follow suit by the end of this year. The convenience and multiple strengths of the pill open the door to “low-dose” weight management.
“That could really create a new market,” says Martinez. “It’s an affordable pill that’s not going to have as many side effects because it’s low dose. It’s probably going to target the market of people who are overweight as opposed to obese, or people whose plans don’t cover the higher-dose obesity GLP-1 drugs.”
At the other end of the spectrum are GLP-1s that enable successively greater rates of weight loss. Health Canada is currently reviewing CagriSema, shown to lower body weight by an average of 23 per cent at the highest dose for people with obesity who do not have type 2 diabetes (compared to 20 per cent for Zepbound and 10 to 15 per cent for Wegovy). On the near horizon is retatrutide (brand name pending), which has demonstrated an average weight loss of 28 per cent during late-phase clinical trials.
7 – What’s coming for GLP-1s
Diabetes and weight loss are just the beginning for GLP-1s. Research is showing that its hormonal mechanism of action could play an important role in treatment for a wide range of conditions, including osteoarthritis, sleep apnea, Parkinson’s disease, kidney disease, liver disease and cancer. It may also be able to treat substance use disorders.
A key point here is the GLP-1 may be an add-on to existing medications. “For example, it’s being studied in combination with a drug that treats psoriatic arthritis, which already costs about $20,000 to $30,000 a year. The GLP-1 could add another $6,000 or $7,000,” says Martinez.
8 – Real-world data coming
Robust real-world evidence is critical to help inform and evolve strategies to cover drugs for weight management. IQVIA’s April 2026 blog, “The outlook for obesity from 2026 to 2030,” cites the Scotland CardioMetabolic Impact Study (SCoMIS) funded by the U.K. and Scottish governments. The three-year study, launched earlier this year, will study whether weight-loss drugs bring healthcare system benefits such as reduced cardiovascular events, diabetes or disability. It may also provide data on wider socio-economic benefits, such as reduced unemployment.