A $450 Missed Fee Made Canada the First G7 Country With Generic Ozempic

Eli Lilly just had one of the biggest quarters in pharmaceutical history. On October 29 the company raised its full-year revenue outlook to between US$91 billion and US$92 billion, after Mounjaro sales jumped 65% to US$10.7 billion and Zepbound brought in US$5.35 billion in three months, according to Lilly's earnings release. CEO David Ricks credited "broad global consumer demand."

Canada is the one big market where the weight-loss drug story is running in a different direction. While Lilly and Novo Nordisk fight over premium prices everywhere else, Canada has become the first G7 country with generic semaglutide, the active ingredient in Ozempic and Wegovy. It got there because of a missed patent fee.

How Did Canada Get Generic Ozempic First?

Novo Nordisk stopped paying to protect it. The company missed a 2019 maintenance fee on its Canadian semaglutide patent and did not pay it, plus a late penalty, during the grace period, Benefits and Pensions Monitor reported. The total owed came to about $450. Canadian retail sales of Ozempic hit $2.5 billion in 2024.

Novo said only that "all intellectual property decisions are carefully considered at a global level." Sandoz CEO Richard Saynor was less diplomatic. "I'm sure someone's lost their job, but never mind. It's the second-largest semaglutide market in the world."

The generics arrived this year. Health Canada approved the first generic semaglutide, from Dr. Reddy's, on April 28, and called Canada "the first G7 country to approve a generic version of semaglutide," in a May 1 announcement that also covered a second approval for Apotex. In June, it approved Apotex's Sevmia, the first generic semaglutide for chronic weight management. Sandoz followed in September.

More are coming. Health Canada said in May that seven more generic submissions were under review.

How Much Cheaper Is Generic Semaglutide in Canada?

A lot, and it should keep falling. Health Canada said generics would be "45 to 90% cheaper" than the brand. Apotex launched at about a third of the brand price, and telehealth companies moved fast, with Felix charging $150 a month and Hims & Hers starting at $149, Benefits and Pensions Monitor reported in May. Hims & Hers' offer is limited to type 2 diabetes patients, Reuters noted.

Canada's pricing rules for generics push prices down as more makers enter. "If you only have one, it comes down from the list price to 75 per cent. If we have two, it goes down to 50 per cent and if we have three it hits 25 per cent," University of Toronto pharmacy researcher Mina Tadrous told CBC. Novo responded by cutting Ozempic prices for uninsured Canadians to stay competitive, Global News reported, without disclosing the new price.

The market is already big. More than a million Canadians use semaglutide, and about 12 million pens are used each year, according to Sandoz's approval coverage. A paper in the Canadian Journal of Cardiology estimated 1.3 to 2.1 million Canadians are eligible, and that generic prices could fall by up to 70%, according to an Elsevier summary.

Who Actually Benefits From Cheaper Semaglutide?

For now, mostly people who can already pay. "The first patients to receive generic semaglutide will likely be those paying out of pocket," Tadrous told Benefits and Pensions Monitor. Public drug plans still do not cover these drugs for weight loss. When the provinces' joint price-negotiating body tried to bargain over Wegovy, the talks were "declined by Novo Nordisk without any offers being exchanged and the file has now been closed," Global News reported. Wegovy's list price was $5,066 a year.

Private coverage is spotty too. Fewer than 20% of Canadians with private drug plans have access to approved obesity medications, Obesity Canada says, even as the share of employers covering GLP-1s for weight loss rose to 37% this year, according to HR Reporter. Generics cut the price that provinces would have to pay, which removes the main excuse for leaving obesity treatment off public plans. Whether provinces act on it is the next fight.

Will Americans Come North for Cheap Semaglutide?

They already did once. In early 2023, 19% of British Columbia's Ozempic prescriptions shipped to Americans, The Logic reported. Novo has since lobbied Ottawa to stop online sales to US buyers, arguing "Canada must take action to protect its drug supply from a country 10 times its size." Pharmacies are regulated provincially, which leaves gaps in federal export rules.

That irony is hard to miss. The company that let its patent lapse is now asking the government to protect the Canadian supply from the demand its own pricing created south of the border. A $450 fee turned Canada into a test case for what happens when the world's most in-demand drug goes generic. Prices are falling, competition is real, and the people who most need help paying are still mostly waiting on their province.