VICTORIA — British Columbia wants a federal government clampdown on prescription rules after thousands of doses of the hyped weight loss drug Ozempic went to Americans, doled out by a single practitioner in Nova Scotia.
Health Minister Adrian Dix said Tuesday that he's asking provincial and federal regulators to look into two Metro Vancouver pharmacies and the Nova Scotia practitioner responsible for thousands of Ozempic prescriptions issued to Americans in the first two months of 2023.
Though the injectable drug is prescribed mainly to treat diabetes, Dix said Ozempic's weight loss side-effects have been hyped up by advertising and celebrity-driven social media chatter.
"The drug's popularity on social media, and the, I think, almost unprecedented campaign of advertising for the drug, is driving a surge in demand and is resulting in shortages of Ozempic, not yet in British Columbia, but in other jurisdictions, including the United States," Dix said.
He said the province is taking action to ensure patients in B.C. continue to have access to the drug and avoid potential shortages.
In the first two months of 2023, Dix said upwards of 15 per cent of Ozempic prescriptions in B.C. were being filled for American patients who receive the medication by mail.
Dix said the situation involving Ozempic is "unacceptable," and noted that less than half a per cent of other drugs in B.C. are prescribed to non-residents.
"We would never have sufficient supply of Ozempic in British Columbia to satisfy the needs of the American market," he said. "We have to protect patients here."
Nova Scotia's Department of Health and Wellness said in a statement that it is aware of the situation and has reached out to the province's College of Physicians and Surgeons about "what is taking place."
"We advise any Nova Scotians with concerns about a physician’s prescribing behaviour to contact the college," the department's statement said.
Dix said it doesn't make sense to allow B.C.'s supply to be drained and exported, driven by increased demand from Americans who have long turned to Canada as a source of cheaper prescription drugs.
The drug's public profile is exceptionally high, and Dix said drug shortages of any type are concerning.
"It's Ozempic today, it might be another drug tomorrow, but I don't think this is a short-term thing," he said. "It's a significant drug and it's part of our PharmaCare system."
Bernie Garrett, a professor in the school of nursing at the University of British Columbia, said off-label marketing of pharmaceuticals has been problematic for years.
He said Ozempic is effective to treat Type 2 diabetes as designed, but it's also effective for weight loss, albeit with significant risks attached, including thyroid cancer as a possible side-effect.
Policing misinformation about pharmaceutical drugs on the internet is difficult, Garrett said, because it's "outside of our regulatory control."
"TikTok videos can be made anywhere," he said.
Garrett said Ozempic may indeed be effective for weight loss, but it's not approved or safe for that use regardless of how "fashionable" it's become due to its celebrity-endorsed social media hype.
"The reason they put these restrictions on the use of these drugs is because they have significant reservations about using them outside of the scope where they've tested them," Garrett said. "People who are doing this are really just being guinea pigs."
Dix said the province is working with the drug's supplier to ensure there's enough Ozempic for diabetes patients in B.C.
He said he wants a federal government review under the Food and Drugs Act "to address the concerning number of Ozempic prescriptions emanating from practitioners in one province."
Ozempic is a high-value and high-demand medication, Dix said, but the large number of prescriptions being shipped to Americans doesn't necessarily mean any rules were broken by the pharmacist or issuing medical professional.
"But I think a reasonable person would say this is not what should happen, that drugs be imported into Canada and then diverted to the United States," Dix said.
He said he's asking the College of Pharmacists of British Columbia to ensure pharmacies are following drug dispensing rules because of the "unusually high" number of prescriptions being filled for non-Canadian residents.
Provincial and federal regulators need to work together to protect the supply of in-demand medications and avoid "mass exportation" of a drug needed by Canadian patients, Dix said.
"It's a national problem. It's a problem across the 10 provinces. This is a drug that's in demand. There's significant off-label use that we all know about related to weight loss," he said. "We need to take some action."
— By Darryl Greer in Vancouver
This report by The Canadian Press was first published March 28, 2023.
Darryl Greer, The Canadian Press
Note to readers: This is a corrected story. A previous version said Dix was asking the B.C. College of Physicians and Surgeons to ensure pharmacies are following dispensing guidelines.