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First New Anti-Obesity Drug in Canada in Two Decades



saxendaOn Friday, Health Canada approved the first new anti-obesity drug for Canadian in nearly two decades.

Thus, soon, Canadians looking for medical treatment for obesity will soon have two prescription drugs available to them – the almost two decades old orlistat (Xenical®) and the soon to be launched liraglutide 3 mg (Saxenda®).

The differences between the two drugs could not be bigger. While orlistat works by inhibiting fat digestion and therefore reduces the number of calories absorbed from fat in the gut, liraglutide is a close analogue to human glucagon-like peptide 1, a gut hormone known to play a key role in insulin secretion and appetite regulation.

Because liraglutide is a peptide, it comes as a once daily injection, not unlike insulin. As an injectable prescription drug, Saxenda is not meant to be taken by anyone, who wants to quickly lose a few pounds. In fact, it takes several weeks of careful uptitration before you even reach the recommended dose for treating obesity – and, as with any obesity medication, you have to stay on it to keep the weight off.

According to Health Canada,

Saxenda® s indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of:

–      30 kg/m2 or greater (obese), or;

–      27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbidity (e.g., hypertension, type 2 diabetes, or dyslipidemia);

and who have failed a previous weight management intervention. 

While seeing this approval is certainly a major step forward in our ability to medically treat obesity, liraglutide is neither effective for everyone nor will everyone tolerate it (the most common adverse effect is nausea). So, hopefully, this is only the first of several new anti-obesity drugs that we can expect to see in Canada in the coming years.

After all, there is no reason why we should not one day have as many drugs to treat obesity, as we have to treat other chronic diseases (e.g. hypertension, diabetes, etc.).

@DrSharma
Edmonton, AB

Disclaimer: I have received honoraria as a speaker and consultant from Novo Nordisk, the maker of Saxenda®.

54 Comments

  1. Is this drug available in the US? That final qualifier: have failed a previous weight management intervention. Hmmm. What if outwardly, we’re “succeeding,” but it’s impacting our quality of life? Would an MD be allowed to declare failure?

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    • It is approved in the US and should be launched in the next couple of months. The current indication is BMI over 30 or 27 plus comorbidities – if diet and exercise does not quite get you there, Saxenda would still be indicated.

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    • Hi not sure were to start .My family Dr. put me on Saxenda but when the pharmacy tried putting it thou they wouldn’t take it my drug plan is threw O.D.S.P.,the dr says it costs 413.00 so as u can see i can not afford this myself. I have chronic back pain depression arthritis so this medication should work great i lose weight my back feels better i feel better mentally cause i look good again i have my health back and my arthritis in the knees should feel better, so nowcomes the big question can u somehow approve this for O.D.S.P. or like the states they give u a card and u only pay 10 % a month , I would like to know how you are going to help me . If I can get on this medication it would helpwith my family i could run around with my grand kids again i could lift them up and hug them all i want . Please help me Thank You Debbie Johnstone

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      • Yes, access to medications for obesity is a big problem as these are often excluded from benefits plans. Unfortunately, the only thing that can change this is the acceptance that obesity is a chronic disease and people living with obesity deserve treatments as much as anyone living with any other chronic disease (e.g. diabetes).

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      • Hi Dibbie
        I am in the same boat as you. I am on odsp and they will not cover it. I called the company that makes it no luck there. I to have a very long list of medical issues as well. My doctor is extremely good to me. He is supplied all the med I need from sample s he gets. So far I have lost 35lbs. It works very good. Talk to you doctor and you may get lucky.
        Best wishes
        Good bless

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        • worked for me..lost 12 lbs in three weeks now off drug and managing weight through diet and exercise my girl friend dropped 13 lbs in just over two weeks..she will go off it next week…great for a weight loss kick start…

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          • Where can I purchase it

          • It’s a prescription medication and can be obtained with a prescription at any Canadian pharmacy

    • What is the next best weight loss medication available(besides Saxenda) or coming to market very soon?

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  2. Pancreatitis? Thyroid cáncer? Hypoglycemia?

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    • It’s all about risk/benefit ratios – like I said, this is not for cosmetic weight loss – we’re talking prescription medication to be used to treat a serious medical condition which has its own risks (diabetes, stroke, heart attacks, breast cancer….).

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      • Would it be available here in canada soon?

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  3. I’ve been on Saxenda for about a month now. I’ve had no side effects at all. I’m on 1.8 mg/day and my appetite is very low. I’ve lost 16 pounds so far. I’m not going up any higher due to the cost, which is about 1000$/ 5 syringes (after the $200 coupon from manufacturer). I’m hoping to continue to losing weight at this dose.

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    • Did you get it in Canada

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    • What a thousand?? My Dr told me the drug company’s representative said the cost was $400.

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        • My insurance company tells me that they will cover the medication, but not the needles. What is the cost of the needles on a monthly basis? (I am in Ontario, if this makes a difference.)

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          • What company do you use? and have you found out the answer of the cost of needles.

          • OMG, please share the info for who told you they will cover the entire cost of the medication. I can buy the needle and im sure it will be much much cheaper. Thank you

  4. My benefit plan does NOTcover cost.
    I see that U.S. site covers $200.00 x12.
    Is there anything available in ( Ontario) Canada?
    Thanks for your time.
    Rita Gallea

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    • You may have to argue with your benefit plan or talk to your employer – the Canadian Medical Association has declared obesity a disease, so why is treatment for this disease not covered? Discrimination?

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  5. Do you need to go on a strict diet and Exersice program to lose weight?

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  6. can I be prescribed victoza instead of saxenda and take a higher dose, if it is the same drug? my insurance pays for victoza but not saxenda?

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    • Your insurance probably only pays for victoza to treat your diabetes as it is not approved for obesity treatment. For obesity you’ll have to talk to your insurer (or employer) about having saxenda covered (if indicated).

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      • my insurance covers NOTHING for weight loss treatment, and who can afford 400.00 per month………….unreal…..if they only could see that by treating for prevention is the real answer, not paying out when all of the other ailments take over from the weight………..someone needs to open their eyes.

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  7. Ive been on Saxenda for over a month, lost 16 lbs the first month, but since been on full dose have not even lost a pound? I have little appatite and my side effects are dry mouth, nausea, headaches and Constipation. I am wondering if i should go back to a lower dose?

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    • Unfortunately, I cannot give personal medical advice on this site. Best to discuss this with your doctor.

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  8. same here, doctor prescribed it and benefit carrier declined. i have inter-cranial hypertension and suffer from both migraines and chronic back pain. tried diets and exercise and no results. how is it the government wants healthier living and such and does nothing to help. approve it and put a max. I don’t mind paying partial but i cannot afford all. benefit carriers cover stupidity in compared to this. my opinion, but if anyone knows please share.

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  9. I live in BC and I went to my doctor and he had never even heard of this! Is it already available in Canada? My bmi is over 30 and I wanted to give this a try. I feel frustrated because of the stigma against treating obesity with medication.

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  10. My dr just suscribed this medication to me I am scared to take it because I am on thyroid medication and I pay 405.00 per month on it… When I so start this where is the best injection site on my body? Is this safe to take with being on Synthroid 88 mg and I also have high blood pressure which i am on medication

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    • I would check with your physician. I also take thyroid medication and my Dr gave me a prescription for Sexanda. The best injection site is the stomach. I am pretty sure they would not prescribe both if they didn’t feel they were ok to take. Hope this helps.

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  11. I had a roux-en-y 7 years ago, lost 80 lbs.and am still at a BMI of 35. I have some trouble with reactive hypoglycemia since then but otherwise I am healthy. I was pre-diabetic before surgery but no anymore. Would I be a candidate for Saxenda therapy?

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  12. Pacific Blue Cross covers Saxenda with no issues at all. If you have a choice in the matter, see if you can get coverage from them.
    If your provider doesn’t cover it: in one of the Saxenda pamphlets they suggest asking your provider very specifically why this medication is not covered, then asking for more details along those lines.
    They also have some kind of savings program to help reduce the cost for up to one year. I don’t know if this is valid in Canada or what the conditions are: https://www.saxenda.com/savings.html.

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  13. Is the ingredients the same as Victoza…. I have been on Victoza for almost two years and it’s very costly like $200 a month. When I inquired about this new weight-loss drug today I discovered it’s a lot cheaper then the Victoza.

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  14. i live in us. how would i go about purchasing Saxenda in canada?

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    • @andrea — did you get an answer to this? Can you share? I’m going through this process now.

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  15. I wonder if my husband plan will.cover this I have to have a referral. He’s local 488 plumbers and pipe fitters. They want a Dr’s reference letter. Anyone try to get covered by local 488? Green shield?

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    • Greensheild will cover it. I’m in Ontario. The pharmacy contacted them & he was sent a 3 page form I had to take to the prescribing Dr. Must have BMI over 30 & a secondary condition relayed to obesity such as sleep apnea.

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      • I am currently with Green Shield and I am trying to get Saxenda covered by them and they will not cover this for me. Any suggestions.

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  16. I live in Carbonear, Newfoundland which is about an hour and a half from St. John’s. I have many health problems example:- DDD, arthritis, fibromyalgia to name a few, which makes exercising very difficult for me. I try to eat health the majority of the time with the occasional treat once in awhile. I have a BMI above 30 and I have been trying to find a doctor that will prescribe Saxenda for me but I am having troubles finding one. Does anyone know of a doctor near me that does or how to find one near me? Any help would be much appreciated!
    Thanks in advance!

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  17. I have diabetes, high cholesterol, anxiety do you think this would work for me….I am overweight 216lbs n 50 years old female.

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  18. I have just been perscribed this drug, and I did advise my dr of my family history. My dad had Thyroid cancer – Medullary of course, and had to have his thyroid removed. I am very concerned about what I should do. I don’t want to go off of it before I even start (the research I know is not conclusive) but I don’t obviously want to speed toward thyroid cancer. Do I trust that my doc has weighed the pros and cons and given my history, he still feels it is a good solution, even if it is short term?
    I really don’t know what to do. I will be calling him tomorrow.

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  19. Been on saxenda for two and a half months lost about 15lbs and on the high dose, no more weight loss and no side effect. Frustrated

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    • Depending on where you started that may be a pretty good result. Average weight loss is about 7-10% of initial (highest) weight. If you stay on it, you should be able to keep most of that weight off.

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      • Yes, there may be a long-term risk, but it is so small that no treatment for this would ever be cost-effective or worth pursuing (definitely not a course of yo-yo dieting!).

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  20. Hello Dr. Sharma,
    I had gastric bypass surgery just over 3 years ago, and have gained about 30 lbs back, and was thinking of trying Saxenda to get myself back on track, do you think it’s okay for someone who has already had weight-loss surgery to take this?

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    • Unfortunately, I cannot give any personal medical advice on this page – this is something you should discuss with your doctor.

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  21. I haven’t been on saxenda since Nov 2017. I was just diagnosed with invasive ductal carcinoma. I read the saxenda PDF on the drug company site. Is the breast cancer finding statistically significant? I also have pain in upper right side. Which I need to check out. While I found this drug to be helpful in weightloss and to reduce large fluctuations in my weight, this is not worth the risk of cancer. Are there any clinical trials studyng breast cancer and saxenda?

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    • Sorry. I have been on saxenda

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    • This is a great question Robby.

      While I cannot give any personal medical advice on this site, here is what is stated about breast malignancies in the Saxenda Monograph (the wording of which is determined by Health Canada):

      “In SAXENDA clinical trials, breast cancer confirmed by adjudication was reported in 17 (0.7%) of 2379 SAXENDA®- treated women compared with 3 (0.2%) of 1300 placebo-treated women, including invasive cancer (13 SAXENDA®- and 2 placebo-treated women) and ductal carcinoma in situ (4 SAXENDA®- and 1 placebo-treated woman). The majority of cancers were estrogen- and progesterone-receptor positive. There were too few cases to determine whether these cases were related to SAXENDA®. In addition, there are insufficient data to determine whether SAXENDA® has an effect on pre-existing breast neoplasia. (see WARNINGS AND PRECAUTIONS, Malignancies, Breast neoplasms)”

      The key issue on why this data is inconclusive (despite the numerical imbalance) is that the number are relatively small. Also, it is important to remember that a numerical greater number of breast cancers have been observed in previous anti-obesity drug trials (e.g. orlistat). It is quite possible that this may in part be due to an ascertainment bias, meaning that weight loss makes the detection of breast cancers (especially in the early stages) much easier and therefore much more likely due to decrease in breast size and softening of breast tissue due to fat loss. Others argue, that the duration of these trials (even at two years) is too short to actually lead to cancer, which generally takes much longer to develop (hence the sentence in the monograph about pre-existing cancers).

      Of course, any treatment (medical or surgical) must always be weighed according to the potential benefit/risk ratio. That is a discussion to be had with your doctor.

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  22. I would like to try Saxenda. I am obese. My bmi is 34. I have had surgery on my Mecklenburg and lower back this past year. I have been trying hard to lose weight and really can’t . I need to lose before I can exercise . What is the best way for me to get treatment . I have been obese off and on since I was 8 years old . Time to turn this around . I want a life.

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  23. Does anyone have manulife for private insurance? Is there a way to get them to cover the cost of Saxenda? My BMI is well over 35 and I have sleep apnea.

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  24. Hi Dr. Sharma. I am a 44 year old female with a BMI of 27 but have bad OA in all of my joints and any excess weight seems to make the pain worse. I’m quite small in stature, approximately 5’2” or 5’ 1” and again depending on the day, about 146-149 lbs so I’m quite overweight. I managed to go from a whopping 202 pounds down to 185 about 5-6 years or so ago and then lost 20 more 3 years ago (165 lbs in 2016). In the summer of 2017 I dropped down to 130.2 pounds which I hadn’t weighed since my late 20’s but have slowly gained back 16-19 of it in the last 2 years since then. I lost all my weight through exercise alone and somewhat diet. The last couple years it didn’t matter what I did exercise wise or how little and healthy I ate, the number keeps creeping up. Now this year I have barely any energy to exercise (just diagnosed with dysgammaglobulemia) and I’m finding it’s like I’m losing the battle I fought so hard to win. I asked my family physician about an rx for Saxenda last winter but he looked at me as though I was speaking another language and said I didn’t need to lose weight (but never even weighed me to see my BMI) and after me telling him I NEED something he gave me a prescription for xenical which, if anything, I may have lost a pound after 2-3 months and it’s pricey too. I’m on disability so have a fixed income but was wondering if you yourself see patients in order to prescribe this or if you are aware of whether there is anyone out there that has been able to have Blue Cross pay even a portion of this medication (aish in Edmonton AB)
    I NEED Something to help me, I’m on quite a few medications for autoimmune diseases, seizure disorder etc too. Any Ideas??

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    • Thank you for sharing your story, unfortunately, I am not able to provide any personal medical advise on this site. Please contact your health professional to discuss this.

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