CDA Pegs Mounjaro Public Coverage at $1.97B Over Three Years

Canada's Drug Agency estimates that listing Mounjaro on public drug plans for type 2 diabetes would cost those plans roughly $1.97-billion over three years, about $820-million more than they currently spend on comparable medications over a similar period [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes].

Draft Recommendation Tied to Discount

The non-binding draft report from Canada's Drug Agency (CDA) recommends that federal and provincial public plans cover tirzepatide, the active ingredient in Mounjaro, in a manner similar to how semaglutide (the active ingredient in Ozempic) is covered — but only if Eli Lilly agrees to a price discount [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes].

According to the report, the list price of Mounjaro was between $300 and $540 as of the beginning of this year, depending on dosage, while the list price of Ozempic was about $228. Those figures exclude pharmacy and distributor markups and cover a four-week supply [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes]. Current verified pharmacy prices tracked on GLP1Prices.ca show Mounjaro ranging from $283.08 to $813 and Ozempic from $222 to $663 per fill, reflecting dispensing and markup variation between provinces.

Dose-by-Dose Pricing Logic

CDA's recommendations vary by dosage. At the low end, the committee found that evidence suggests five-milligram dosing of Mounjaro is similar in effectiveness to one milligram of Ozempic, so 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 report generally recommends public plans seek a discount of 25 to 49 per cent off the Mounjaro list price [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes]. The suggested discount typically serves as a starting point for negotiations between the manufacturer and the pan-Canadian Pharmaceutical Alliance (pCPA), which represents public drug plans [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes].

Generic Semaglutide Complicates the Math

The CDA report notes that generic forms of Ozempic are currently being reviewed by Health Canada, and that when those products reach 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].

Health Canada has nine generic semaglutide medications under review, with the agency's target timeline for initial review of a generic drug set at 180 days [Source: cbc.ca/news/health/generic-ozempic-canada-waiting-9.7142339]. Mina Tadrous, associate professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto, estimates generics might be available by this summer or early fall, with prices potentially around $100 a month or less once enough generics come online [Source: cbc.ca/news/health/generic-ozempic-canada-waiting-9.7142339]. Readers can follow approval status through our generic semaglutide tracker.

Lilly Responds to Draft

Ethan Pigott, director of communications and external affairs at Eli Lilly Canada, said in a statement that despite the positive draft recommendation, the company had concerns about some of the details, noting that the draft "does not fully reflect the totality of evidence for Mounjaro" versus semaglutide 1 mg. He 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 explaining why. CDA is still examining Lilly's applications for sister drug Zepbound, which contains the same active ingredient; Lilly is seeking public coverage for Zepbound for both weight management and sleep apnea indications [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes].

Pricing Backdrop

Mounjaro's Canadian price has shifted multiple times since Health Canada approved it in late 2022. Eli Lilly initially sold the drug in a cheaper vial form, raised prices and moved patients to a KwikPen injectable in 2025, then reduced prices by 20 per cent or more depending on dosage at the end of that year [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes]. New list prices for Mounjaro and Zepbound KwikPen presentations took effect on December 29, 2025 [Source: glp1prices.ca/blog/eli-lilly-mounjaro-zepbound-price-cut-canada-2026].

Public plans spent $794-million on Ozempic in 2024 [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes]. Patients shopping for coverage details can use our insurance coverage checker or consult our FAQ for more on how listings work.

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