Blue: Public-plan spending on Ozempic. Green: Private weight-management drug claims. Sources: CIHI public drug spending data; TELUS Health Drug Data Trends report; Globe and Mail / IQVIA Canada. Private claims index (right axis) is estimated from TELUS Health reporting that weight management spending more than quadrupled since 2021 and doubled in 2024 following the launch of Wegovy.
The broader benefits picture
Total claims paid out by Canadian insurers for weight-loss drugs spiked to $77 million in 2024, up from nearly $38 million the year prior, reported the Globe and Mail. However, group benefits and health policy consultant Chris Bonnett, Principal of H3 Consulting, offers a broader lens on the financial stakes. He says that focusing narrowly on price misses the bigger clinical picture: “The biggest mistake all drug plans make is weighing coverage based on price, cost, or budget impact without understanding the clinical effects and overall value to patients, other payers, and society at large,” says Bonnett.
He points to the complexity of comorbidities as a key consideration: there are 13 cancers associated with obesity and overweight, and between 20 and 30 per cent of cancer patients are also diagnosed with diabetes, heart disease, depression, or anxiety. Treating these conditions in isolation, he says, is a strategic error.
Bonnett believes that national pharmacare is unlikely to change this equation much in the near term. The federal program covers a limited formulary of older diabetes drugs in only four jurisdictions – representing just 18 per cent of Canada’s population – and GLP-1 drugs remain ineligible, so private drug plans will continue to play a critical role in patient access, he says.