Since enacting a new regulation to curb the sale of the diabetes drug semaglutide (Ozempic) to people who do not reside in British Columbia and Canada, the number of dispenses to U.S. residents has dropped more than 99%.

To protect the supply of semaglutide drugs for diabetes patients in B.C., on April 19, 2023, a drug schedules (limits on sale) regulation was enacted to impose conditions on the sale of semaglutide, which includes drugs such as Ozempic, Rybelsus and Wegovy, by pharmacies. The new regulation was introduced in response to a high percentage of the dispenses of Ozempic being purchased by U.S. patients from pharmacies located in British Columbia, in an environment where surging demand in some jurisdictions created shortages.

To help prevent online or mail-order sales of Ozempic to people who do not reside in Canada and who are not in B.C. to make the purchase, the regulation allowed B.C. residents, other Canadian citizens and permanent residents to buy Ozempic through B.C. pharmacies both in person and online, while others could only purchase the drug in person at a pharmacy.

From Jan. 1, 2023, until April 19, there were 30,700 Ozempic dispenses from B.C. pharmacies to people with U.S. addresses. From April 20 until May 31, there were 111 Ozempic dispenses from B.C. pharmacies to people with U.S. addresses, representing a reduction of 99.1%.

PharmaNet data review indicated that an unusually high percentage of prescriptions for Ozempic were coming from one practitioner in Nova Scotia and that these prescriptions were being predominantly dispensed by two internet pharmacies in British Columbia.

After the College of Pharmacists of BC informed the College of Physicians and Surgeons of Nova Scotia about this concern, the physician in question was temporarily suspended. The College of Pharmacists of BC’s investigation into the two online pharmacies that dispensed thousands of Ozempic prescriptions in January and February 2023 is ongoing.

Semaglutide is in a class of medications called incretin mimetics that help the pancreas release the right amount of insulin when blood sugar levels are high. Drugs with the active ingredient semaglutide treat Type 2 diabetes mellitus under the brand name Ozempic, an injectable, and Rybelsus, a tablet, and also treat obesity under the brand name Wegovy.

BC PharmaCare provides coverage for Ozempic as a second-line therapy for Type 2 diabetes to help patients manage blood-sugar levels when metformin is not effective. The cost is not reimbursed for weight loss. Currently, pharmacies in B.C. can fill prescriptions for patients written by U.S. doctors if they are co-signed by a Canadian practitioner. There is no shortage of Ozempic in B.C. or in Canada. One of the side-effects of Ozempic is weight loss, and it has gained popularity through social media as a weight loss medication.

Staff from the Ministry of Health continue to work with staff at Health Canada, the College of Pharmacists of BC, and other stakeholders to explore measures that can be taken to address safe online retail of prescription drugs.

Learn More:

Learn about actions to protect B.C.’s supply of semaglutide: https://news.gov.bc.ca/releases/2023HLTH0046-000554

Learn about BC PharmaCare: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents

Learn about Ozempic coverage in B.C.: https://news.gov.bc.ca/releases/2023HLTH0031-000398 and https://news.gov.bc.ca/releases/2023HLTH0001-000004