Health Matters: B.C. wants federal clamp on weight and diabetes

The bad news is: B.C.’s supply of a wonder drug is being gamed by a small number of dubious medical practitioners and pharmacists.

The good news is: The Health Ministry is attacking the problem a lot faster than government normally reacts when loopholes are exploited.

Health Minister Adrian Dix announced a number of steps Tuesday to tackle a strange local impact from the current mania over the latest greatest miracle drug, Ozempic. The injectable drug was designed to treat certain specific Type 2 diabetes conditions. But it seems to work for weight loss as well. Celebrities and “social media influencers” locked on to that and it has created a huge demand for the drug that is wildly out of proportion to the narrow segment of the population for which it was developed.

You can tell something about the ethics of Ozempic’s developers that they are catering to the off-label demand with one of the biggest advertising campaigns for a new drug ever seen.

Dix called it “hype” and said it is visible across all media.

The not-so-subliminal message is: “Here’s a new diabetes drug — check the Kardashians et al for some side-benefits.”

It’s working great. Shortages are developing in the U.S. due to intense demand. And with cross-border internet pharmacies capitalizing on price differentials an established trend, customers are looking north. There are various Canadian websites filling prescriptions for U.S. citizens at prices far below the going rate in the U.S.

B.C. expanded Pharmacare coverage in certain diabetes-related situations for Ozempic, which can cost up to $300 a month, in January. But tracking prescriptions for the subsequent two months via the Pharmanet system showed the provincial supply is being gamed.

An unusually high percentage of dispenses are being purchased by U.S. patients from B.C. pharmacies. Fifteen per cent of Ozempic prescriptions through February were filled for U.S. citizens. The average share of other drugs sold to U.S. citizens is 0.4 per cent.

The data indicates that just two B.C. pharmacies were responsible for 13,197 (88 per cent) of the 15,798 dispenses to U.S. residents. (The phrase “pill mills” comes to mind.)

Further, 95 per cent of those prescriptions were written by one or more prescribers who identified themselves as a practitioner from Nova Scotia. Currently, pharmacies in B.C. can fill prescriptions for patients written by U.S. doctors if they are co-signed by a Canadian practitioner.

“The purpose of procuring the drug Ozempic for British Columbia is not to turn around and export it to Americans,” Dix said.

“It is to make sure patients in British Columbia and Canada requiring the drug to treat their Type 2 diabetes can continue to access it.”

He served notice that regulations will be changed to limit sales to non-Canadian where there are potential supply issues. And there are potential supply issues right now.

A monitoring agency reports a Canadian shortage of Ozempic in one milligram form at the moment.

The Pharmacare coverage for the drug is limited to use as a second line therapy when other diabetes drugs are not effective. It is not approved for weight loss.

Dix is also asking the medical colleges for doctors and pharmacists to ensure it is being used for its original designated purpose.

He said the extraordinary number from Nova Scotia is concerning, so he’s writing to all Canadian health ministers asking them to review the problem. He wants the Nova Scotia College of Physicians and Surgeons to investigate the exceptionally high number of prescriptions being farmed out from there to other provinces.

He said “it does not make sense” for a few Nova Scotia doctors to prescribe the drug for people all over the U.S. and have them buy it from two pharmacies in metro Vancouver.

“I trust that our federal and provincial partners will support B.C. and look into these very serious issues.”

The job is to curb the excessive Ozempic shopping in Canada without curtailing legitimate access. Dix noted that cross-border drug shopping goes both ways, as Canadians go to the U.S. to get insulin on occasion.

“We will be cautious and thoughtful in the development of the actions we are taking.”

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