Medicine Canada

While politicians tout the benefits of reducing interprovincial trade barriers to unlock prosperity amid escalating trade tensions, our most precious health-care resources — fully qualified doctors — remain shackled. Physicians face a maze of regulations when attempting to practise beyond their home province. We must break these chains.

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Authors:

• Anthony Sanfilippo - professor of Medicine (Cardiology), Queen's University, Ontario
• Neil Seeman - Senior Fellow, Institute of Health Policy, Management and Evaluation, University of Toronto, and Adjunct Professor, Dalla Lana School of Public Health, University of Toronto

The Alberta government wants to cut more than $400 million in the fees it pays to doctors, according to a confidential memo obtained by The Canadian Press.

The Feb. 18 memo, sent by Alberta Medical Association head Dr. Shelley Duggan to member physicians, says Alberta's health ministry seeks cuts to more than 800 physician billing codes to save $400 million because of budget pressures.

Those codes lay out how much money is paid for specific procedures, sometimes based on the amount of time that a doctor spends with a patient.

"What has become clear in the last few months is that Alberta Health is looking to address its budget shortfalls through the physician services budget," Duggan writes.

"While we hope Alberta Health will reconsider its current approach, we wanted to advise members that it's highly likely the [issue] will proceed to arbitration."

Duggan says the government move breaks an agreement to jointly review the billing changes because the province has not left enough time for a proper evaluation before a March 31 deadline.

Generic versions of Ozempic could be available in Canada as early as next year, making Canadians among the first in the world to get cheaper copies of the type 2 diabetes drug that has become a sales and cultural juggernaut because of its weight-loss benefits.

At least four companies have applied to Health Canada to sell copies of Ozempic after its market exclusivity expires on Jan. 4, 2026. Health Canada accepted submissions from the Canadian company Apotex in January and from Switzerland-based Sandoz in November, according to the regulator’s website.

Health Canada also accepted applications from two other unnamed companies in the first quarter of last year, before the regulator enacted a policy naming the manufacturers behind generic drug submissions on April 1, 2024.

Apotex and Sandoz declined interview requests, but Sandoz’s chief executive officer Richard Saynor told Bloomberg in December that his company plans to use the Canadian market as a trial balloon for generic versions of semaglutide, the active ingredient in Ozempic. In the United States and Europe, Ozempic remains on patent for several years.

“If the price comes down from, I don’t know, a few hundred or a thousand dollars a month to a few tens of dollars a month, the patient population’s size is insane,” Mr. Saynor told the business news outlet.

The market for Ozempic in Canada is already huge: Just more than $2.5-billion worth was sold through Canadian retail pharmacies last year, according to the life-science analytics company IQVIA – making Ozempic far and away the best-selling prescription drug in the country. (IQVIA’s figures include markups and dispensing fees.)

Ozempic reached that high-water mark despite Canadian public and private drug plans generally declining to cover it for weight loss, an off-label use.

That means an untold number of Canadians are already using their own money to buy the drug, and more may be willing to do so if the price drops, according to University of British Columbia professor Michael Law, who holds a Canada Research Chair in Access to Medicines.

“We have good evidence that folks are price responsive when it comes to prescription drugs,” he said. “If the price goes down to 35 per cent of what it is now, it’s likely that there will be more people willing to pay for it out of pocket.”

Canada’s tiered pricing framework for generics dictates that injectable drugs such as Ozempic be sold at 35 per cent of the branded product’s list price if there are three or more generic competitors, as there likely would be for such a lucrative market.

Ozempic’s Canadian list price is $218 for four weekly doses, which means generic copies should sell for $76 for a four-week supply before markups and dispensing fees. The list price in the United States is a little less than US$1,000, although, as Novo Nordisk, the drug’s Danish maker, points out, American diabetics with health insurance rarely pay that amount.

Williams Lake, B.C., launched a recruitment and retention strategy in 2022 that it says is showing results

When doctors Jacques and Mariska Neuhoff take their two kids to the park in their home in Williams Lake, they can just let their kids play.

And they never forget just how special that is.

They moved to the Interior B.C. community of around 11,000 people five years ago from Pretoria in South Africa. They didn't want their children to have to grow up in gated communities.

The couple estimates they spent about three years and around $60,000 on flights and exams before being certified to practise as family doctors and anesthesiologists.

"It's a very long and tough process," said Jacques.

But what awaited them was something special.

"We came into a home with a stocked fridge and a pantry from the community that put it there for us," said Jacques.

The couple said people were knocking on the door every day, bringing dinner and welcoming them to the community.

Three years ago, local city and health officials decided to formalize and fund that warm welcome the Neuhoff's received and make it part of their recruitment and retention strategy.

The city, with funding from the Cariboo Chilcotin Regional Hospital Board, hired two healthcare landing co-ordinators with the aim of attracting long term and locum doctors to the city and the nearby District of 100 Mile House.

Province also celebrating recruitment of 1,001 new family doctors in 2 years

Osborne says the province is changing its licensing rules so U.S.-trained doctors can begin practising in B.C. right away, without any need for further assessment, exams or training.

She said there will be a similar scale-back of the barriers facing U.S.-trained nurses and that a marketing campaign will be unveiled in Washington, Oregon and California within the next few months.