Canadian GLP-1 coverage — 12 month update

This is great info, thank you all. Let me ask the follow-up question: is anyone using compounded semaglutide in Canada? I know the regulatory environment is different here — Health Canada's approach to compounding is somewhere between the US and Australia.

I've seen a couple of Canadian compounding pharmacies advertising semaglutide on Instagram but I'm not sure about the legality or quality.

Compounded semaglutide exists in Canada but it's a grey area. Under the Food and Drugs Act, pharmacies can compound medications that are commercially available only if there's a specific patient need (allergy to an excipient, custom dosing, etc.). "It's cheaper" is not a valid reason under Health Canada guidelines.

That said, enforcement is minimal. I know of at least two compounding pharmacies in Ontario doing semaglutide at about $150-180 CAD/month. They require a prescription. Quality-wise, one of them publishes Janoshik COAs on their website — showed 99.1% purity on the last batch.

NAPRA (National Association of Pharmacy Regulatory Authorities) released guidance in late 2025 suggesting provincial colleges of pharmacy should crack down. Ontario College of Pharmacists sent a warning letter to compounders in January. So the window may be closing here too, similar to Australia.

One more BC tip — the BC PharmaCare Special Authority process has an expedited pathway if your doctor codes it as "urgent." My GP did this when my HbA1c came back at 64 mmol/mol and I had the SA approval in 4 business days instead of the usual 2-4 weeks.

Also, for anyone in Atlantic Canada: I believe Nova Scotia and New Brunswick both cover Ozempic through their respective Pharmacare programs with similar T2D restrictions. PEI might be the only province with zero public coverage for any GLP-1 — someone from the Maritimes confirm?

Excellent thread. I'm going to compile this into a proper table/spreadsheet and share it. The province-by-province variation is staggering — we really need a national pharmacare strategy for these medications.

Key takeaway for Canadians: if you have T2D, you can likely get Ozempic covered through your provincial plan with some paperwork. If you want semaglutide or tirzepatide for obesity only, you're either paying private ($300-400+/month) or relying on employer insurance. Québec may change this soon.