You’ve seen it in the news, on billboards and even social media. Here at Saskatchewan Blue Cross, we field a lot of questions… but what exactly is this drug everyone is talking about?
What is Ozempic?
Ozempic is a brand name of the drug semaglutide, which has been approved by Health Canada as a treatment for adults with Type 2 diabetes. It simulates something called glucagon-like peptide-1 (GLP-1) in the body and is delivered weekly with a self-injectable pen.
GLP-1 is a hormone that encourages the body to create more insulin, which assists people with Type 2 diabetes as it lowers blood sugar levels. GLP-1 also assists in reducing food cravings, which can result in weight loss with patients.
Why is everyone talking about it?
Ozempic continues to be in the news – but not for its intended purpose of managing Type 2 diabetes. Many people have been taking it for weight loss. Studies show that Ozempic can help patients lose anywhere from 6 to 11 per cent of their body weight over the course of three to six months when taking the drug. Many doctors have prescribed Ozempic for patients concerned with weight management. As the increase in demand for Ozempic goes up, the global supply chain has seen shortages in the drug’s availability.
How is Saskatchewan Blue Cross managing this drug?
Saskatchewan Blue Cross has approved benefit coverage for Ozempic for the treatment of Type 2 diabetes as indicated by Health Canada. Health Canada is Canada’s regulatory body that approves drugs and indication for their use, providing guidance on prescription drugs. At Saskatchewan Blue Cross, we aligned our Special Authorization criteria to follow the approved use of Ozempic.
Special Authorization is required for Ozempic benefit coverage. This means patients will have to pay out-of-pocket if their doctor has prescribed the drug for anything other than the treatment of Type 2 diabetes. We are communicating directly with all patients who will not have their claim covered if their doctor prescribed Ozempic only for weight loss. Additionally, anyone who has been newly prescribed Ozempic for Type 2 diabetes will have to pay out of pocket until a diabetes diagnosis is confirmed.
What is available to plan members who want to lose weight?
Saskatchewan Blue Cross plans can support members who are looking for weight management solutions. This includes health and wellness lifestyle information as well as medications. Saskatchewan Blue Cross covers a range of Health Canada approved drugs designed specifically for weight loss including Contrave, Saxenda and Xenical depending on the type of plan you hold.
You can also visit our Wellness Weekly blog to access articles to enhance your health and wellness such as:
We’re here to help.
If you have any questions or to submit a Special Authorization request, please contact our Member Experience Centre at 1-800-667-6853 or send us a message using our Contact Us form.