A Supply Crisis
Since late 2024, Canadian pharmacies have faced persistent shortages of semaglutide (Ozempic) and related GLP-1 receptor agonists. The problem stems from a perfect storm: surging global demand driven by off-label weight loss prescriptions, limited manufacturing capacity at Novo Nordisk's facilities, and Canada's relatively small market share making it vulnerable to supply disruptions.
Patients who depend on these medications for type 2 diabetes management have been particularly affected. Some have reported going weeks without their prescribed dose, leading to dangerous blood sugar fluctuations and emergency room visits.
The Off-Label Demand Problem
A significant portion of the shortage is attributed to off-label prescribing for weight loss. While semaglutide is approved for obesity treatment under the brand name Wegovy, the chronic shortage of Wegovy has pushed many physicians to prescribe Ozempic instead, further straining the diabetes supply.
Health Canada issued guidance in early 2025 urging physicians to prioritize diabetes patients, but enforcement has been difficult. Provincial colleges of physicians have taken varying approaches, with some issuing formal advisories and others leaving it to individual clinical judgment.
What Patients Can Do
Diabetes Canada recommends that patients maintain a two-week buffer supply when possible, communicate regularly with their pharmacist about expected restocking dates, and discuss backup treatment plans with their endocrinologist. For some patients, switching to liraglutide (Victoza) or dulaglutide (Trulicity) may be viable alternatives, though these medications have their own supply constraints.
Looking Forward
Novo Nordisk has announced a $6 billion expansion of its manufacturing facilities, with new production lines expected to come online in late 2025 and 2026. In the meantime, Canadian advocacy groups are pushing for a national strategy to ensure equitable access to essential diabetes medications.
