CDA Mounjaro Math: Lilly's $300 Floor Meets a 25-49% Discount Ask

Canada's Drug Agency has issued a draft recommendation that public plans cover Eli Lilly's Mounjaro for Type 2 diabetes, but only if the manufacturer agrees to a discount 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/].

What the draft recommendation says

The Canada's Drug Agency (CDA) draft, published in the spring of 2026, gave tirzepatide a generally positive review and suggested public plans treat it similarly to semaglutide [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. At the low end, CDA's committee said the evidence suggests 5 mg Mounjaro is similar in effectiveness to 1 mg Ozempic, and that public plans should pay no more for Mounjaro at that dose than they pay for Ozempic [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

At higher dosages, the report recommends a discount of 25 to 49 per cent off list price [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. The Globe and Mail reported the list price of Mounjaro was between $300 and $540 as of the beginning of this year, depending on dosage, while Ozempic's list price sits at about $228, with both figures covering a four-week supply before pharmacy and distributor markups [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Lilly's December cut already moved the floor

The CDA discount ask arrives after Eli Lilly cut Canadian list prices on Mounjaro and Zepbound by 20 per cent or more, with the new prices taking effect December 29 [Source: reuters.com/business/healthcare-pharmaceuticals/eli-lilly-cuts-price-diabetes-weight-loss-drugs-canada-globe-mail-reports-2025-12-18/]. Reuters reported the Canadian list price of a four-week supply of Mounjaro or Zepbound dropped to $300 for the 2.5 mg and 5 mg doses, while 7.5 and 10 mg doses were set at $420 for a four-week supply [Source: reuters.com/business/healthcare-pharmaceuticals/eli-lilly-cuts-price-diabetes-weight-loss-drugs-canada-globe-mail-reports-2025-12-18/].

Those reported list prices sit inside the current range of pharmacy cash prices tracked on GLP1Prices.ca, which run from $283.08 to $800 for Mounjaro and $276 to $609 for Zepbound across our sample. The Globe and Mail noted Mounjaro's price has gone through ups and downs since Health Canada approval in late 2022, including a 2025 hike tied to a move from vials to a pen format, followed by the late-2025 cut of 20 per cent or more depending on dosage [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

What it could cost public plans

If public plans cover Mounjaro, CDA estimates it could cost them $1.97-billion over three years — about $820-million more than the plans currently spend on comparable drugs over a similar period [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. For context, public plans spent $794-million on Ozempic in 2024, according to the most recent data cited in the Globe and Mail report [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

CDA's recommendations are non-binding and typically serve as a starting point for negotiations between the manufacturer and the pan-Canadian Pharmaceutical Alliance [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Ethan Pigott, director of communications and external affairs at Eli Lilly Canada, said in a statement that the draft does not fully reflect the totality of evidence for Mounjaro and that the company would engage constructively with CDA [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

How Canada compares to the U.S. benchmark

The CDA file is unfolding while U.S. pricing for the same class is also moving. CBC News reported the Trump administration's TrumpRx program will allow people to buy drugs directly from manufacturers starting in January, with average prices starting around US$350 and dropping to US$245 over the next two years [Source: cbc.ca/news/health/ozempic-trumprx-cheaper-insurance-9.6970197]. CBC also reported Canadians currently pay anywhere from $300 to $500 per month for GLP-1 medications, including semaglutide brands such as Ozempic and Wegovy [Source: cbc.ca/news/health/ozempic-trumprx-cheaper-insurance-9.6970197].

Open questions

• CDA's report notes that when generic forms of Ozempic hit the market the price of Ozempic will fall substantially, which could affect future cost-effectiveness analysis of Mounjaro [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].
• CDA is still examining Eli Lilly's applications for Zepbound for two separate conditions [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, with the company not saying why [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Patients comparing options can review our generic semaglutide tracker, the insurance coverage checker, and our FAQ for additional context on pricing and coverage.

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