The weight-loss drug Wegovy, made by the manufacturers of Ozempic, will be available to patients in Canada starting Monday, the company says.
Novo Nordisk’s weekly injection is approved for weight loss among patients diagnosed with obesity.
Wegovy can also be prescribed to patients who are significantly overweight and have at least one related medical condition such as high blood pressure, Type 2 diabetes or obstructive sleep apnea.
Health Canada approved Wegovy in November 2021, but it’s taken about two and a half years to bring it to market amid supply shortages of Ozempic, which is only approved to treat Type 2 diabetes but has been prescribed off-label for weight loss.
The two drugs have the same active ingredient but Wegovy carries a higher weekly dose of semaglutide at 2.4 milligrams, compared to 1 mg in a single Ozempic dose.
Dr. Ehud Ur, an endocrinologist in Vancouver, said Wegovy allows Novo Nordisk “to segment out the two markets for obesity and diabetes.”
“But, you know, they’re intimately related,” said Ur, who is not affiliated with Novo Nordisk.
“I mean, much of diabetes is caused by obesity. Many people with obesity are prone to developing diabetes. So it’s a complex interaction.”
Health Canada approved Wegovy based on studies that “demonstrated a statistically significantly greater amount of weight loss in semaglutide-treated (patients) as compared to placebo-treated subjects,” according to the federal government’s website.
Semaglutide mimics a hormone called glucagon-like peptide-1 (GLP-1) which promotes insulin production. It also suppresses appetite in the brain and works in the stomach so people feel fuller when they eat.
The insulin effect to treat diabetes can be achieved with a lower dose of semaglutide, but a higher dose increases the appetite suppressant effect, which is why Wegovy is a higher dose than Ozempic, Ur said.
Clinical trials showed that Wegovy was not only safe and effective for weight loss, but also had a positive impact on other weight-related conditions such as cardiovascular health, he said.
Dr. Sanjeev Sockalingam, scientific director for Obesity Canada, said obesity is a medical condition and Wegovy will be an important treatment option.
“(Wegovy) adds to the tool box and the tool kit for all clinicians who are seeing many patients living with obesity,” said Sockalingam, whose organization estimates at least eight million Canadian adults have obesity.
Obesity Canada will update its medication guidelines to include Wegovy, which is meant to be used in tandem with physical activity and nutrition, he said.
Obesity is defined as a body mass index (BMI) of 30 kilograms per square metre or greater, according to Health Canada.
In addition to patients with obesity, doctors can prescribe Wegovy to patients with a BMI of 27 kilograms per square metre and at least one weight-related medical condition. That could include hypertension, Type 2 diabetes, dyslipidemia (an imbalance of lipids such as cholesterol or triglycerides) and obstructive sleep apnea.
Wegovy arrives after extensive marketing of Ozempic and a social media-driven surge in demand for its off-label use for weight loss. Experts say it’s critical that prescribers, including family doctors, ensure Wegovy is only given to patients who meet specific criteria.
“Physicians are ultimately the gatekeepers of this, and hopefully there will be responsible prescribing for the medication,” said Ur.
Sockalingam stressed that when it comes to prescribing Wegovy, “we want to make sure we’re very precise, that we’re not talking about … cosmetic or physical appearance.”
“This is a medical treatment for a medical condition.”
The founder of a support group for people living with obesity called the arrival of Wegovy in Canada “a milestone moment.”
“(It is) signaling a growing recognition of obesity as a serious health issue that requires comprehensive treatment solutions,” said Priti Chawla, executive director of Obesity Matters.
But the high cost of Wegovy raises the issue of equitable access, Chawla said.
“Many in our community, and especially those in the lower socioeconomic bracket, they find these treatments are financially out of reach,” she said.
“It’s essential that we work towards making Wegovy affordable and accessible to all Canadians who need it.”
Novo Nordisk Canada would not provide a specific price for Wegovy to The Canadian Press, saying in a statement that “medication pricing in Canada is influenced by multiple factors including federal, provincial and territorial governments and insurance providers, and prices may vary person to person.”
But multiple experts estimated it would likely cost around $400 a month.
Now that there is a drug specifically approved for weight loss, insurance companies “have to state specifically whether they will or will not cover this product,” said Dr. Sean Wharton, an internal medicine specialist who treats patients with Type 2 diabetes and obesity in the Toronto area.
Wharton conducts research with several drug companies developing diabetes and weight loss medications, including Novo Nordisk.
The most common side effects found in Wegovy clinical trials were gastrointestinal, including nausea, vomiting diarrhea, constipation and abdominal pain, said both Ur and Wharton.
Starting with a low dose and gradually increasing it to the 2.4 mg maintenance dose should help alleviate those symptoms, they said.
Some participants in the study also reported headache, fatigue and dizziness, Novo Nordisk’s Wegovy web page said.
Semaglutide has been associated with thyroid tumours in rodents, the web page said.
There has never been a case of thyroid tumours in humans taking Ozempic or Wegovy and there is no evidence to suggest any risk to humans, Wharton said.
Ur agreed, saying someone would only be at risk if they were among the “handful” of people in Canada who already have the rare thyroid tumour.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
