Canadian GLP-1 coverage — provincial formulary comparison

British Columbia (PharmaCare):

• Ozempic: Covered under Plan B (Fair PharmaCare) with Special Authority approval. Your endocrinologist or GP submits the SA request — takes 2-4 weeks. Same T2D-only restriction as Ontario.
• Wegovy: NOT covered under PharmaCare.
• Mounjaro: Special Authority pathway approved in January 2026. Very new, some pharmacies are still figuring out the billing.

Cost without coverage: Ozempic runs about $300-340 CAD/month at Shoppers Drug Mart. I've found London Drugs consistently $15-20 cheaper.

One BC-specific thing: if you're on income assistance (PWD), semaglutide IS covered through Plan C without the Special Authority hassle.

Québec (RAMQ):

We have the most aggressive coverage in Canada, honestly. RAMQ added semaglutide to the Liste des médicaments in 2024 with médicament d'exception status for T2D.

But here's where it gets interesting: Québec's INESSS (our HTA body, like CADTH for the rest of Canada) recommended coverage of Wegovy for obesity in their November 2025 report. RAMQ hasn't acted on it yet, but it's expected by mid-2026. If approved, Québec would be the first province to publicly cover semaglutide for obesity.

Out-of-pocket cost in QC for non-covered Wegovy: approximately $380 CAD/month at Jean Coutu.

Alberta:

Our system is a mess. Alberta doesn't have universal PharmaCare like BC or Ontario's ODB. Drug coverage is through:

• Alberta Blue Cross (non-group): Covers Ozempic for T2D after Special Authorization. $25 copay per script.
• AISH (disability): Full coverage for Ozempic.
• Seniors' benefit: Covered with SA for T2D.

If you don't fall into one of these categories and don't have employer insurance, you're paying full freight. And Alberta's dispensing fees are among the highest in Canada — I've been charged $12.50 per fill on top of the drug cost.

No coverage for Wegovy or Mounjaro through any Alberta public plan as of June 2026.

Manitoba (Pharmacare):

Manitoba Pharmacare is income-based, so it's complicated. You pay a deductible based on family income (about 2-5% of adjusted family income), then Pharmacare kicks in.

Ozempic IS on the formulary for T2D. With Pharmacare covering it, once you hit your deductible, you pay a $0 copay. Wegovy is not listed. Mounjaro was added February 2026 under Part 1 with EDS criteria.

Practical note: I had to try and fail metformin AND a sulfonylurea AND a DPP-4 inhibitor before Manitoba Pharmacare would approve the EDS for Ozempic. That's three prior authorizations, each requiring 3-month trials. It took me almost a year of documented failures before I could start semaglutide.