Market Update: Canada will be a launching pad in the global race for generic Ozempic – Full Analysis

At the stroke of midnight on New Year’s Eve, Danish drugmaker Novo Nordisk recorded another milestone in Canada: for the fourth year in a row, its blockbuster drug Ozempic was the highest-earning prescription drug in the country.

And not just by a little bit, but by a lot. Ozempic earned $2.9-billion in 2025, according to aggregated prescription data collected by IQVIA Canada, an analytics company. The next best-selling medication was a psoriasis treatment that brought in less than a third as much as Ozempic.

Wegovy – another Novo Nordisk drug made with the same active ingredient as Ozempic – earned $635-million. Combined sales of the two drugs totalled $3.5-billion, a growth of 31 per cent over the previous year.

But something else happened less than a week into 2026 – a change that may significantly change those sales figures this year, even while demand for the weight-loss and diabetes drugs explodes.

On Jan. 4, Novo Nordisk’s last remaining market protections on the sale of Ozempic and Wegovy in Canada expired. The next day, generic semaglutide became legal. The power to manufacture and sell the hottest drug in the country is no longer kept by one company.

Now, the global pharmaceutical industry’s eyes are on Canada, the first major market in the world where cheaper forms of Ozempic are legal.

How will cheaper versions of Ozempic tip the scales?

The opportunity for all players is enormous: the global demand for weight-loss and diabetes drugs is estimated to surpass US$150-billion annually by the early 2030s, according to Morgan Stanley analysts in a recent report.

“This is likely to be a very big market, it’s growing at a rapid lift,” said Evan Seigerman, managing director and head of healthcare research at BMO Capital Markets in New York.

“In terms of what this means for the broader population, I think that we’re going to see these products become more accessible and more widely available.”

The rush to cash in extends well beyond the drugmakers themselves. Companies involved in the sale of these drugs – such as pharmacies and virtual-health startups – are getting ready for an expected surge of new customers.

“Our prediction would be that we’re going to see, even though it’s going to be significantly cheaper, that we will sell more,” said Per Bank, chief executive officer of Loblaw Companies Ltd, the parent of Shoppers Drug Mart, on a call with analysts in November. The company has recently launched its own virtual-care service to prescribe and dispense weight-loss drugs.

Mr. Bank added: “So many customers now, they will have access to that drug, which is good for us, good for customers and good for health care in Canada.”

As generics roll out in Canada, declining prices will be a boon for patients taking the drug and those who previously couldn’t afford it. More than a million Canadians are already on semaglutide, but that pales in comparison to what drugmakers see as the total addressable market: the two-thirds of Canadians who are considered overweight or obese according Statistics Canada.

For drugmakers, who need to leap over regulatory and manufacturing hurdles this year to reach the prize, the race is on.

In many countries, Ozempic sales started to explode in 2022. That year, videos about the drug went viral on TikTok and other social-media platforms. By early 2023, the drug was a fixture in the pop-culture mainstream; while hosting the Oscars that March, Jimmy Kimmel quipped: “Everybody looks so great. When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?’”

The drug’s steep trajectory is evident in Canadian sales data. Sales of Ozempic at retail pharmacies totalled just $126-million in 2019, according to IQVIA Canada. By 2025, that had increased to $2.9-billion.

For many of the nearly two million Canadians estimated to have tried the drug, it may be the first time they’ve been required to take weekly injections.

At the Durham Care Clinic and Pharmacy in Oshawa, Ont., pharmacist and co-owner Khalid Bhatti takes a blue, plastic, cylindrical pen off the shelf in a small white room to the right of his pharmacy counter.

“This is the Ozempic pen,” he said. He turns a dial at the end of the pen with a click to adjust the dose. “With this one, you can dial it to point-two-five,” he said. That’s 0.25 mg of semaglutide, the active ingredient in Ozempic, taken weekly.

“This is the starting dose, and then point-five for the second month,” he says, adjusting the dial again.

The pen is pressed into a patient’s body to deliver a subcutaneous injection, meaning a needle that goes into the fatty tissue under the skin. “You can do the back of the upper arms or the thighs, but the stomach is usually easy and well tolerated,” he said.

He and his staff – including doctors, dietitians and fitness coaches – specialize in helping patients who need treatment for diabetes and obesity. They’ve been doing more and more of these demonstrations since the clinic opened in 2021.

Ozempic is part of a class of drugs called GLP-1s, which mimic gut hormones that the body produces naturally to slow digestion and reduce appetite. Research funded by Novo Nordisk found that patients using Wegovy lost, on average, about 15 per cent of their body weight over 68 weeks.

The first drugs in the GLP-1 class were liraglutide (under the brand names Victoza and Saxenda), which were approved for diabetes and weight management, respectively, in 2010 and 2015. Ozempic was approved for Type 2 diabetes in 2018, and Wegovy (prescribed for obesity) was approved in 2021.

It’s not clear why Canada became the first place the drug’s legal protections ended.

Novo Nordisk was issued its main patent for semaglutide in 2013, according to the Canadian patent database, which contains public copies of letters between the government and the drugmaker.

The letters show that in 2019, Novo Nordisk was warned that it was late making an annual maintenance fee on the patent. In August of 2020, the patent expired because of the missed payment.

Another type of legal protection called “data exclusivity,” which covers the drug’s clinical trial data, blocked generics until Jan. 5 of this year.

Although the public records show what happened, they do not explain why. Novo Nordisk has so far been tightlipped. “Our IP strategy is confidential,” said spokesperson Kate Hanna. “I can tell you that all decisions are globally considered.”

The absence of a definitive explanation has led to widespread speculation in the industry. A common theory points out that, at the time Ozempic was coming to market, a struggle was playing out between the federal government and the pharmaceutical industry over pricing regulation and the role of a quasi-judicial body called the Patented Medicine Prices Review Board (PMPRB).

In 2017, the federal government announced it wanted to give new powers for the review board that would allow it to more actively police “excessive” drug prices. But it only does so for drugs with active patents. So, the theory goes, Novo Nordisk let its patent lapse early to avoid the potential of more aggressive oversight from the review board, even if it meant having to contend with generics years earlier. (Most of the reform was ultimately abandoned after a series of successful court challenges, of which Novo Nordisk Canada was a party.)

Thomas Digby, a B.C.-based intellectual-property lawyer and chair of the review board from 2023 to 2025, said that “if it’s true that Novo abandoned its Ozempic/Wegovy patent in order to avoid PMPRB review, choosing instead to face generic entry, then it’s completely unprecedented in my experience, and quite possibly a strategic business mistake.”

Patent protections will lapse in India and Brazil in March, and in China and Turkey later in the year. The U.S. patent is good until 2032.

Already, a number of generic drug makers are champing at the bit in Canada. Health Canada records and corporate disclosures show six companies have applied to make generic semaglutide: Dr. Reddy’s Laboratories Ltd., Sandoz Canada Inc., Apotex Inc., Taro Pharmaceuticals Inc., Aspen Pharmacare Canada Inc. and Teva Canada Ltd.

None of the new generics have yet been approved as Health Canada continues to work through the submissions with the companies. Industry experts expect at least one or two approvals to come by the spring, with many more by the end of 2026.

Novo Nordisk recently got approval from Health Canada to market semaglutide under the additional names of names Plosbrio and Poviztra, which the company said it may use to compete with the cheaper generics.

The opportunities extend beyond pharmaceutical companies.

In the northern Italian city of Como, near the Swiss border and the Alps mountain range, sits the Steriline manufacturing facility. The Italian maker of lab equipment has spent three years working with an Alberta company called Applied Pharmaceutical Innovation to design and build an advanced robotic filling line that will sterilize vials and bottles, fill them with medication in precise amounts and safely seal the containers.

After a journey by truck and boat, the equipment will arrive in Canada this year and become one of the largest filling lines of its kind in this country. And the first commercial product it will be used to make at API’s Edmonton facility is generic semaglutide. Specifically, it will produce the formulation created by Vimy Pharma, a new pharmaceutical company founded by two former executives at Novo Nordisk’s Canadian offices, which will soon file its submission to Health Canada.

Dave Suchon, the chief executive officer of Vimy Pharma, said he and co-founder Farris Smith formed the company to create a Canadian-made and Canadian-owned producer of generic semaglutide.

He said he expects the immense size of the growing market means there is plenty of room for the brand-name and generic competitors to compete.

“It won’t be a zero-sum game,” he said.

Once at least three products are on the market, the price of generic semaglutide will be set at 35 per cent of the Ozempic list price, as outlined in a pricing framework agreed to between a national body called the pan-Canadian Pharmaceutical Alliance and the Canadian Generic Pharmaceutical Association, an industry group. It is also possible for public health plans to negotiate even deeper discounts.

As generics muscle into the market, brand manufacturers – such as Novo Nordisk and Eli Lilly & Co – are seeking new sales channels and product variations.

Novo Nordisk will try to advance semaglutide in other markets by continuing to research new applications for the drug. For example, in December, Health Canada approved Wegovy to treat some forms of serious liver disease.

“We’re committed to this molecule,” said Ebele Ola, Novo Nordisk Canada’s vice-president of clinical, medical and regulatory affairs. “We see a lot of impact that it can have.”

Semaglutide is a peptide, produced by Novo Nordisk from yeast cells. Generic companies are developing ways to chemically synthesize the drug, and they have talked about Canada being an important market for them to figure out how to do so before they sell it in other countries.

“A product like this is an opportunity for us to show what we’re capable of,” Michel Robidoux, Sandoz’s general manager for Canada, said in an interview in November.

Interest in semaglutide is also changing how patients buy drugs. In the U.S., widespread demand for Ozempic has helped turbocharge consumer use of virtual pharmacies.

But virtual adoption has been much smaller in Canada, where such sales are estimated at less than 10 per cent.

Felix Health, a Canadian telehealth provider, said demand for GLP-1 prescriptions on its platform have doubled in the last year – and about 85 per cent of those clients pay out of pocket. Patients can get a prescription from a nurse practitioner through Felix’s online platform, and then get their medication delivered to their door in an insulated box.

Felix Health chief executive officer Kyle Zien said that since the company launched in the summer of 2019, it has facilitated a million medical consultations – and almost a quarter of them were for people looking to shed pounds. “Weight loss is certainly our fastest growing category within the business,” he said.

Kelly Anderson, Felix’s medical director and an emergency physician, said the company takes verification of prescriptions seriously. She or another clinical lead at the company aim to audit about 25 per cent of visits after they are completed to monitor prescription practices.

Brett Belchetz, co-founder of the Maple telehealth platform and also an emergency physician, said his company – which prescribes but does not dispense – entered the GLP-1 space somewhat reluctantly.

He said the tipping point came in early 2025 when the clinical evidence became “overwhelming” that GLP-1 drugs were becoming the standard of care for obesity.

“We felt if our patients were going to be getting these drugs regardless, it was best that we offer it to them in a manner that we thought was safe.”

Novo Nordisk is getting in the game, too. In September, the company announced it would work with virtual pharmacy Pocketpills to expand home delivery of Ozempic and Wegovy in Canada.

In the U.S., Novo Nordisk had been working with telehealth provider Hims & Hers until the two companies had a falling-out when Novo Nordisk claimed Hims & Hers was selling “knock-off” compounded semaglutide on the platform.

Hims & Hers announced in December that it was now live in Canada and aimed to start selling generic semaglutide as soon as it was available.

Adam Dudum, the company’s co-founder and chief executive officer, said it would use its experience in Canada to help plan for further international expansion as generic semaglutide becomes legal in more countries.

“I think it’s going to be a case study that we can then think about and learn and try to apply in other key markets,” he said.

Novo Nordisk essentially created the GLP-1 market, and in Canada the company still dominates. But in the United States, it’s in a fierce competition.

The only other major GLP-1 drugs on the market are Mounjaro and Zepbound (both made with tirzepatide), from U.S. drugmaker Eli Lilly & Co.

In Canada, Mounjaro earned $403-million in 2025, from less than a tenth the number of prescriptions as Ozempic.

But that’s not the case in the United States. There, Novo Nordisk could not keep up with the staggering demand and there were frequent shortages throughout 2022 and into early 2025.

That created an opportunity Eli Lilly was ready to exploit. The company made major in-roads in the U.S. market and reported in November that 57.9 per cent of GLP-1 prescriptions in the United States were for its products.

Research has also generally suggested tirzepatide achieves better results, as it mimics the effects of GLP-1s and another hormone known as GIPs.

For example, a study published in the New England Journal of Medicine in 2021 found that patients on tirzepatide lost an average of 7.6 kg, 9.3 kg or 11.2 kg, depending on dosage, while those on semaglutide, all on the same dosage, lost an average of 5.7 kg over 40 weeks. (The study of of 1,879 adults with Type 2 diabetes was funded by Eli Lilly.)

“With this new class of medication, we are reaching levels of efficacy that are really unprecedented,” said Mathilde Merlet, Eli Lilly’s general manager for Canada.

Eli Lilly, meanwhile, has been on a tear. Its stock went from around US$150 a share in early 2020 to now trading above US$1,000. It became the first pharma company to hit a US$1-trillion valuation in November. And with a widely hyped oral GLP-1 drug due to be approved by the U.S. Food and Drug Administration in the coming months, Eli Lilly is seen by investors as having the wind in its sails.

“Their fundamentals are so much stronger,” BMO Capital Markets’ Mr. Seigerman said.

Novo Nordisk, meanwhile, has seen its stock drop from almost 1,000 Danish Krone in the summer of 2024 to around 300 Krone in December of 2025. The company named a new CEO last July, announced in September it would lay off 9,000 people – about 11 per cent of its global workforce – and replaced most of its board in November.

One reason Mounjaro hasn’t made the same impact in Canada is that it has been much more expensive than semaglutide. Ozempic’s list price is $223 for a four-week supply (not including markup from distributors or pharmacies). By the summer of 2025, Mounjaro could be more than twice as expensive, depending on the dosage.

That may be beginning to change. On Dec. 29, Eli Lilly reduced the list price of Mounjaro and Zepbound to between $300 and $540 depending on dose, a drop of 20 to 30 per cent from its previous prices.

The newest race is shaping up to be on the pill form of the drugs, which analysts think could increase demand because of convenience and for patients who are averse to needles.

Health Canada has already approved a pill version of Ozempic called Rybelsus. Novo Nordisk’s pill form of Wegovy was approved in the U.S. in December, and the company expects Health Canada approval by the end of 2026. Eli Lilly’s weight-loss pill, orforglipron, has been submitted to the FDA and the company says it expects approval by the spring.

Some of the biggest GLP-1 players have their roots in one of Canada’s most famed inventions.

In the early 1920s, Canadian researchers discovered insulin. Danish scientist August Krogh and his wife Marie visited the University of Toronto lab of John Macleod, Frederick Banting, Charles Best and James Collip, and obtained a licence to manufacture the hormone.

Dr. Krogh ultimately founded the company that became Novo Nordisk, which today manufactures about half of the world’s supply of insulin. The company has become a powerhouse of the Danish economy and, at times, Europe’s most valuable company.

Insulin also powered the rise of Eli Lilly in the past century.

Many in the industry believe that GLP-1s for treating diabetes, obesity and more could be next great advancement for the pharmaceutical industry.

“We continue to believe that diabesity is set to become among the largest pharma categories in history,” Morgan Stanley analyst Terence Flynn wrote in a year-ahead note to clients in December.

And Canada will help shape it.