CDA Draft: Cover Mounjaro With 25-49% Discount at Higher Doses

Canada's Drug Agency (CDA) has issued a draft recommendation that public health plans should cover Eli Lilly's Mounjaro for Type 2 diabetes, contingent on the manufacturer providing a discount, with suggested price reductions of 25 to 49 per cent off list price at higher dosages [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Inside the Draft Recommendation

CDA, a government-funded non-profit that issues non-binding recommendations to federal and provincial drug plans, said tirzepatide — the active ingredient in Mounjaro — should be reimbursed in a manner similar to semaglutide, the active ingredient in Ozempic [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. The draft report was published Thursday [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

At the lowest dose, the agency's committee concluded that the evidence suggests five-milligram dosing of Mounjaro is similar in effectiveness to one milligram of Ozempic, and that public plans should pay no more for Mounjaro at that dosage than they pay for Ozempic [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. At higher dosages, the committee recommends a discount in the 25 to 49 per cent range off Mounjaro's list price [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

List Prices and DB Comparison

According to The Globe and Mail, Mounjaro's list price was between $300 and $540 as of the beginning of this year, depending on dosage, while Ozempic's list price is currently about $228 — figures that exclude pharmacy and distributor markups and represent a four-week supply [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Pharmacy-level prices on GLP1Prices.ca currently range from $283.08 to $813 for Mounjaro and from $200 to $663 for Ozempic, reflecting markups added on top of manufacturer list prices.

Three-Year Budget Impact

If public plans cover Mounjaro, the report estimates the cost could reach $1.97 billion over three years — about $820 million more than plans currently spend on comparable drugs over a similar period [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Public plans spent $794 million on Ozempic in 2024 [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

The report also notes that when generic semaglutide reaches the Canadian market, the price of Ozempic will fall substantially, which could affect future cost-effectiveness analyses of Mounjaro [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Health Canada currently has nine generic semaglutide medications under review, with a target initial review timeline of 180 days [Source: cbc.ca/news/health/generic-ozempic-canada-waiting-9.7142339].

Eli Lilly Response

Ethan Pigott, director of communications and external affairs at Eli Lilly Canada, said in a statement that despite the positive draft, the company had concerns about some of the details [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Pigott wrote that "the draft does not fully reflect the totality of evidence for Mounjaro" and said Eli Lilly would "engage constructively" with CDA as it finalizes its recommendations [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Eli Lilly first filed a Mounjaro application to CDA in 2022 and later withdrew it, without publicly stating why [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Zepbound Still Under Review

CDA is still examining Eli Lilly's applications for Zepbound, which contains the same active ingredient as Mounjaro [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Eli Lilly is seeking public coverage for Zepbound for two separate conditions: weight management and sleep apnea [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Health Canada approved Zepbound on May 13, 2025, and Eli Lilly launched the medication at Canadian pharmacies on July 9, 2025 [Source: walkin.ca/blog/zepbound-canada/].

Prescription Trends in the U.S.

South of the border, weekly IQVIA data cited by Morgan Stanley showed Mounjaro reached approximately 758,400 total prescriptions for the week of April 17, 2026, up from 749,500 the prior week [Source: ca.investing.com/news/stock-market-news/eli-lilly-stock-slips-despite-steady-glp1-script-growth-93CH-4585646]. Eli Lilly's total GLP-1 franchise — including Mounjaro, Trulicity, and Zepbound — maintained approximately 59% weekly new prescription market share, unchanged from the prior week, while the overall GLP-1 category grew approximately 32% year over year [Source: ca.investing.com/news/stock-market-news/eli-lilly-stock-slips-despite-steady-glp1-script-growth-93CH-4585646].

Canadians can monitor product status using GLP1Prices.ca's generic semaglutide tracker and review benefit options through the insurance coverage checker. Additional background is available in the FAQ. Other branded GLP-1 medications in Canada include Wegovy and Rybelsus.

This article is for informational purposes only and does not constitute medical advice.