Dr. Iris Gorfinkel, a family physician in Toronto, is concerned about widespread over-prescribing of popular weight-loss drugs. She is particularly raising alarm bells over the forthcoming generic versions of semaglutide and tirzepatide injections (Ozempic and Mounjaro, respectively). Novo Nordisk and Lilly produce these medicines first to restore blood sugar control for people living with Type 2 diabetes. Recently though, they’ve experienced a surge of fame due to their extraordinary weight-loss capabilities. As the diabetes medication landscape continues to change, Gorfinkel emphasizes the importance of responsible use. Generics are soon to come, and with that change, it is particularly important to be informed.
Ozempic and Mounjaro, the weight-loss wonders, have invaded the minds of the many hoping to be more financially secure while controlling their weight. Dr. Gorfinkel uses Ozempic herself to help her tackle “food noise” and stay on track with her weight loss. She cautions that a significant number of patients discontinue use because of the long-term side effects. Patients commonly discontinue treatment owing to intolerable adverse reactions including nausea, vomiting, diarrhea, and abdominal pain. These concerns lead to questions around the sustainability of these weight-loss medications for long-term use.
With Health Canada currently reviewing nine generic semaglutide medications for approval, patients might soon see these more affordable options become available. The estimated cost of these generics could be around $100 a month or less, potentially making them accessible to a wider audience. Over 50 generics are expected to enter the Indian market within months, most likely increasing the spillover competition in this tempestuous sector.
Cost and Accessibility
The cost implication of GLP-1 drugs has been a focal issue for patients. As Dr. Nav Persaud recently pointed out, patients are rightly frustrated with the hefty price tags attached to these prescription drugs. He hopes that bringing generics to market will help ensure these innovative treatments are more accessible to those who need them for the maintainable future.
“I think, ironically, we would actually probably see less of that if the medication was lower in price,” – Dr. Nav Persaud
For people like Sarah Brooks, the economic realities are clear-cut. She has a typical benefits plan that allows her to go to a maximum of only $2,000 per year. Unfortunately, if she has that much, she risks spending it all just on her drugs.
“Our benefits allot us $2,000 a year, and I’m gonna blow that all on [the meds],” – Sarah Brooks
Brooks says her tragic hope is that the costs don’t wind up being even higher. This is a reflection of the increasing anxiety felt by patients who depend on these medications for functional and cosmetic outcomes.
The Shift in Perception
That’s what Dr. Gorfinkel notices too—many of his female patients are the ones aggressively pursuing GLP-1s. Perhaps they only want to lose a stubborn 10 or 15 pounds for purely cosmetic reasons. This dramatic turn of the tide raises moral questions about the medicalization of weight management.
According to Obesity Canada, the annual cost of untreated obesity in our country is unfathomable — an estimated $27.6 billion. This trend towards greater usage of GLP-1s shows our society’s growing willingness to accept medical interventions for weight loss. With this expansion, automatic misuse or overuse becomes a danger, especially as generics are released into the market.
Dr. Macklin how the potential introduction of generics would represent huge progress.
“By expanding access, it could counter bias as more people have that ‘aha’ moment,” – Dr. Macklin
He’s convinced that broader access to more affordable medication can make all the difference in the world for patients living with obesity.
“It’s an extremely exciting prospect that individuals living with this real disease have access to a remarkably safe and effective medication,” – Dr. Macklin
Caution Against Misuse
While the mood is mostly upbeat around generics, health advocates are careful yet hopeful to avoid their misuse. Dr. Persaud cautions that many patients may not be happy about their decision to take these medications. This may occur if the medications do not produce the result expected.
“In that situation, most people regret having taken the medication and wish that they had never heard of it because they’re out the money and they are at the same weight or higher than when they started.” – Dr. Nav Persaud
With the promise of more affordable options, big questions remain about how we will help people manage their weight-loss journeys alongside these therapies. Dr. Gorfinkel’s critique of the overuse of these dangerous drugs identifies troubling issues. Though they can have huge benefits in controlling weight and diabetes, they present real risks that we can’t dismiss.
The Canadian market is preparing for a wave of new generics. One domestic company is clearly aiming to make its mark, with plans to roll out a made-in-Canada alternative to Ozempic. This important initiative will help to add even more competition to the market and give local patients more choice to meet their unique needs.
