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British Columbia

What is Ozempic and why is B.C. cracking down on sales of the drug to Americans?

Thousands of people in the U.S. have been getting the diabetes drug Ozempic from pharmacies in B.C. this year, prompting the province to announce a restriction on sales to avoid a local shortage. Here's how Americans are turning to pharmacies north of the border and why.

Pharmacists can legally mail medication to the U.S., but expert questions ethical obligations

A blue needle with the brand name
Ozempic is pictured in a file photo from May 2022. Buyers who might not have diabetes have been seeking out the medication because celebrities, advertisements and people on social media have hyped up its potential for weight loss. (Shutterstock)

Thousands of people in the United States have been getting their Ozempic this year from pharmacies in British Columbia, prompting the province to announce a restriction on sales to avoid a local shortage of the diabetes medication.

At a news conference Tuesday, Health Minister Adrian Dix detailed the results of an internal ministry investigation into the cross-border issue, saying thatnearly one in five Ozempic prescriptions in B.C. went to American residents in the first two months of the year.

The vast majority of those prescriptions were issued in Nova Scotia and fulfilled by two Metro Vancouver pharmacies, the investigation found.

Here's how buyers from the U.S. are turning to pharmacies north of the border and why.

What is Ozempic?

Ozempicis the brand name of aninjectable drug prescribed mainly to treat Type 2diabetes.

Bernie Garrett, a professor in the school of nursing at the University of British Columbia (UBC), said it'salso effective for weight loss albeit with significant risks attached, including thyroid cancer as a possible side-effect.

B.C. Diabetes has also noted the potential for weight loss.

Why is there so much demand?

Buyers who might not have diabetes have been seeking out the medication because celebrities, advertisements and people on social media have hyped up its potential for weight loss.

The drug is not approved as aweight loss treatment in Canada, but Dix said demand from the U.S.is affecting supply across the country.

Patients in the U.S. are turning to Canadian pharmacies to buy the drugs for cheap. In B.C., one month of Ozempic costs around $300 a third of some American prices.

Prescription drugs can cost less in Canadabecause a federal agency sets the maximum price a company can charge for patented drugs. In the U.S., drug companies are allowed to decide.

WATCH | B.C. to restrict Ozempic sales under rising demand from U.S.:

B.C. to limit Ozempic sales as demand soars

1 year ago
Duration 1:59
British Columbia plans to restrict how much Ozempic can be sold to people outside Canada to prevent a shortage from happening as demand for the diabetes drug soars amid weight loss claims.

Dozens of users on TikTok and Reddit trade information about accessing the medication in Canada. Some say they can't afford the drug in the U.S. without insurance, or that their insurance won't cover the drug without a diabetes diagnosis.

People who have received the drug from Canadian pharmacies say the medication is shipped in a matter of weeks, sealedin a package with ice packs.

How are people in the U.S. getting Ozempic from Canada?

In the first two months of the year, upwards of 15 per cent ofOzempicprescriptions in B.C. were being filled for American patients.

By comparison,less than half a per cent of other drugs in B.C. were prescribed to non-residents.

Americans can also crossthe border to buy prescription drugs in Canada, and this has become more common in recent years. Americans doing so still need a prescription from a physician licensed in Canada to buy Canadian pharmaceuticals.

They can visit a walk-in clinic and pay out-of-pocket for the visit. Some Americans living nearthe border might even have a family doctor in Canada. Doctors of B.C. says it's not illegal for general practitioners in Canada to provide care for non-residents, but it's not actively encouraged.

Is it legal for pharmacists to mail Ozempic out of the country?

As long as the prescription is written or co-signed by a Canadian prescriber, it's legal for a pharmacist to fill that prescription and send it to the patient.

Sending medication by mail isn't uncommon if, for example, the patient is a Canadian snowbird living in the U.S. part time.

Still, pharmacists have the right to refuseprescriptions that come across their counters.

"If you know that it's for an off-label use ... and if it's not for a patient that you know, as a pharmacist myself, I would have second thoughts about whether this is the right treatment decision for this supply of a drug that is intended for British Columbians," said Barbara Gobis, a pharmacistand the director of the pharmacist clinic at UBC.

WATCH | American demand for B.C. stock of Ozempic is 'concerning,' minister says:

Number of Americans buying B.C.'s Ozempic stock is 'concerning,' health minister says

1 year ago
Duration 1:41
B.C. Health Minister Adrian Dix said the province needs to restrict the amount of Ozempic that can be sold to non-Canadians, particularly U.S. residents, as demand for the diabetes drug soars because celebrities have said it can help with weight loss.

If it's legal, why is the province restricting sales?

Dix said the province wants to preserve its stock of Ozempicto be sure British Columbians with Type 2 diabetes can access the drug. The province isn't currently experiencing a shortage, but Dix said"the trend is in that direction."

Just this year, the provincialgovernment expanded access to Ozempic for British Columbiansthrough PharmaCare's special authority program.

Dix said Tuesday the province doesn't have enough stock to help British Columbians and"satisfy the American market."

Dix saidhe's asking provincial and federal regulators to look into two Metro Vancouver pharmacies and the Nova Scotia practitioner responsible for thousands of Ozempic prescriptions issued to Americans.

He said he wants a federal government review under the Food and Drugs Act "to address the concerning number of Ozempic prescriptions emanating from practitioners in one province.''

He said he's asking the College of Pharmacists of British Columbia to ensure pharmacies are following drug dispensing rules because of the "unusually high'' number of prescriptions being filled for non-Canadian residents.

Provincial and federal regulators need to work together to protect the supply of in-demand medications and avoid "mass exportation'' of a drug needed by Canadian patients, Dix said.

"It's a national problem. It's a problem across the 10 provinces. This is a drug that's in demand. There's significant off-label use that we all know about related to weight loss,'' he said. "We need to take some action.''

Have there been shortages of Ozempic elsewhere?

Demand for Ozempic has driven shortagesin the United States.

Canada experienced a temporary national shortage of the drug's one-milligram format in March, but Health Canada and the drug's manufacturer told CBC News the issue was resolved last week.

With files from Rhianna Schmunk, Eva Uguen-Csenge, Lyndsay Duncombe, Yvette Brend, Canadian Press