OTTAWA — Karine Matteau has been looking forward for years to this coming January, when diabetes and weight-loss drugs Ozempic and Wegovy lose their Canadian patent protection.

As vice-president in charge of the commercial office of Sandoz Canada, one of the country’s largest generic drugmakers, that’s her job.

“As soon as an innovative brand is on the market, we flag it and we follow it,” she says. That meant Sandoz knew far in advance when Danish pharma company Novo Nordisk would lose its exclusive rights in Canada. Swiss-headquartered Sandoz, and several competitors, are preparing to deliver copies of Novo Nordisk’s widely demanded appetite-controlling medications to Canadians as soon as January 2026.

Ozempic is officially a diabetes treatment and Wegovy is for obesity, but both are based on the same amino acid, called semaglutide. Novo Nordisk has had a Canadian patent on semaglutide for years but got lax about the paperwork to maintain it until its “natural” end in March 2026. After a $450 fee went unpaid in 2019, a countdown to the earlier expiry began.

That will make Canada the first major market where generic semaglutide drugs can be sold.

Meanwhile, demand for semaglutide treatment has soared in Canada, though it’s difficult to put hard numbers on.

Claims for Ozempic almost tripled between January 2022 and June 2023, according to an annual report from Telus Health that tracks prescription trends for drugs covered by private health plans. Prescriptions dipped soon after as insurance companies cracked down on “off-label” prescriptions, which patients were using to get Ozempic for weight loss because it’s officially a diabetes treatment.

Even so, Ozempic accounted for more than 45 per cent of the value of all insured diabetes prescriptions in Canada in 2024, Telus Health reported.

But then the value of prescriptions of weight-management drugs more than doubled from $37.9 million in 2023 to $77.6 million in 2024, a change Telus Health attributed primarily to Wegovy’s arrival in Canada in May last year.

Multiple competitors want to crowd Canada’s semaglutide market when the doors open wide in a few months. Sandoz submitted its generic semaglutide for Health Canada’s approval last summer, Matteau said, after coming up with a way to make it entirely synthetically—that is, without using living cells in the process, as Novo Nordisk’s version does. That makes for an easier regulatory pathway.

Open data from Health Canada says it accepted Sandoz’s version of the drug for review in November. The department is considering multiple such applications, including from Toronto-headquartered Apotex, and from Taro (a subsidiary of India’s Sun Pharma). None of the others responded to The Logic’s requests to talk about their plans.

Two other applications are in Health Canada’s database, too, but those were accepted before a rule change in early 2024 made submitters’ names public.

To be clear, none has regulators’ approval yet. Sandoz, however, is proceeding as if its drug will be on the market soon.

“Canada is the second-largest semaglutide market in the world” after the United States, says Matteau. “So in terms of size of opportunity, this is huge.”

What the advent of generic semaglutide will mean for prices depends on how many companies’ versions hit the market. An agreement between manufacturers and provincial drug plans largely dictates what companies like Sandoz can charge for generics. If three or more companies sell generic versions of the same drug in Canada, the “reference price” is 25 per cent of the brand-name price for pills, or 35 per cent of the price for more complicated delivery systems.

As injectables, clones of Ozempic and Wegovy would be in the latter category. That could cut the monthly price of treatment from about $400 to about $135.

Sandoz contends the current price is keeping some people, especially diabetics, off the most appropriate medicines.

“We think that with bringing a more affordable generic version of semaglutide, more patients will now finally have access to something that would be more effective for them,” Matteau said.

Canada is something of a global test case. Novo Nordisk’s protection for its semaglutide drugs is expiring in Brazil, India and China in March, a couple of months after it happens in Canada.

Matteau said she doesn’t expect billboard campaigns vying to convince you that, say, Apotex’s semaglutide is better than Sandoz’s, or vice versa. She used to do sales and marketing for Sanofi and Novartis, which develop new brand-name drugs, and for those the objective is usually persuading patients that a new product can help them: “You need to create that behaviour change, you need to push that mode of action,” she said.

The trick in marketing a generic drug, Matteau says, is convincing people—patients, yes, but mostly prescribers and pharmacists—that it’s exactly as good as the brand-name version, just cheaper. That means supplying good information on subjects like how to take it (semaglutide drugs are injections, so they’re more intimidating than pills), what the side effects could be and how to handle them.

“It’s more than a dog-and-pony show. It’s more about being there for our customers, and that includes patients,” Matteau said.

Where Canada might see open competition, however, is among companies that want to write the prescriptions for new generics.

Hims & Hers Health, an American online service that specializes in drugs for afflictions like obesity, hair loss and sexual problems, said in July that it would expand to Canada in 2026. It said plainly that the move will be “timed with the anticipated first-ever availability of generic semaglutide anywhere in the world.”

“Canada is a major opportunity to show what affordable, high-quality weight-loss care can look like,” CEO Andrew Dudum said in announcing the plans.

(Hims & Hers briefly had an agreement with Novo Nordisk for brand-name Wegovy earlier this year, offering a bundled deal of US$599 a month for Hims & Hers virtual health appointments and Wegovy injections. Novo Nordisk terminated the arrangement in June, angrily accusing Hims & Hers of “deceptive promotion and selling of illegitimate, knockoff versions of Wegovy.” Hims & Hers countered that Novo Nordisk improperly pressured its doctors to prescribe Wegovy instead of other anti-obesity treatments.)

Felix, a Canadian service in a similar business—its home page prominently advertises treatments for weight loss with an image of a woman giving herself a shot—is also anticipating the arrival of generic versions of Ozempic and Wegovy, though more cautiously.

“The introduction of generics has historically provided more optionality to patients, and this dynamic will soon extend to semaglutide, commonly known for treating diabetes and obesity,” co-founder and CEO Kyle Zien said in a written statement after The Logic asked for an interview. “We prioritize maintaining strong relationships with supplier partners, both brand and generic, to ensure supply chain integrity and optionality.”

Just what to prescribe will be up to Felix’s medical practitioners, Zien wrote.

Though it’s a profitable 102-year-old pharma company with multiple product lines, semaglutide drugs are particularly important to Novo Nordisk. In a statement at the end of July, the company sharply lowered projections of its total sales and profit growth from expectations it had published in May, attributing the revisions almost entirely to worse-than-projected sales of Ozempic and Wegovy. Last week, it announced it was cutting about 9,000 jobs, or roughly 11 per cent of its global workforce. 

In the meantime, its shares have taken a beating, falling from a peak of more than US$148 on the New York Stock Exchange just over a year ago to about US$56 now.

Novo Nordisk’s roots are in Canadian insulin; its founders started the company by taking the discovery to Danish patients more than a century ago. Its Canadian arm says it’s ready for whatever happens with semaglutide here.

The company is now advertising possible discounts on Wegovy through media such as bus-shelter ads. Eligible patients can get cards entitling them to partial insurance-type coverage, through a third-party provider called innoviCares. (In the U.S., Novo Nordisk has slashed the price of Ozempic for patients who buy it from the company’s own pharmacy service.)

“Novo Nordisk Canada is well equipped to navigate the evolving market landscape that accompanies loss of exclusivity for semaglutide,” spokesperson Amy Snow said in an email. “The company remains committed to supporting both health-care professionals and patients by facilitating informed choices and continuing to address the considerable unmet needs of individuals living with Type 2 diabetes and obesity.”