Tirzepatide Pricing Path: Lilly's December Cut Meets CDA Review

Eli Lilly's December 2025 price reductions on tirzepatide products in Canada set the stage for the Canada's Drug Agency review that recommended public plans cover Mounjaro for Type 2 indications, with negotiated discounts of 25 to 49 per cent off higher-dose list prices [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

The December 2025 price cut

According to a note Eli Lilly issued to pharmacies and reported by The Globe and Mail, the Canadian list price of a four-week supply of Mounjaro or Zepbound was lowered to 300 Canadian dollars for the 2.5 mg and 5 mg doses [Source: reuters.com/business/healthcare-pharmaceuticals/eli-lilly-cuts-price-diabetes-weight-loss-drugs-canada-globe-mail-reports-2025-12-18/]. The higher 7.5 mg and 10 mg doses were set at 420 Canadian dollars for a four-week supply, with the new prices taking effect on December 29 [Source: reuters.com/business/healthcare-pharmaceuticals/eli-lilly-cuts-price-diabetes-weight-loss-drugs-canada-globe-mail-reports-2025-12-18/]. The reductions represented cuts of 20 per cent or more depending on dosage [Source: reuters.com/business/healthcare-pharmaceuticals/eli-lilly-cuts-price-diabetes-weight-loss-drugs-canada-globe-mail-reports-2025-12-18/].

CDA's coverage framework

Canada's Drug Agency, a government-funded non-profit that issues non-binding recommendations to federal and provincial health insurance plans, examined Eli Lilly's submission and published a generally positive draft recommendation [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. The report says tirzepatide should be covered in a similar way to semaglutide, the active ingredient in Ozempic [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

The list price of Mounjaro was between $300 and $540 as of the beginning of 2026, depending on dosage, while the list price of Ozempic was about $228 [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Those figures cover a four-week supply and do not include pharmacy and distributor markups [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Current pharmacy listings tracked on GLP1Prices.ca show Mounjaro ranging from $283.08 to $813 CAD across 103 samples, reflecting markups above the list reference.

Dosage-tiered recommendations

CDA's recommendations vary by dosage:

• At the low end, the agency's committee says the evidence suggests five-milligram dosing of Mounjaro is similar in effectiveness to one milligram of Ozempic, and 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 recommends public plans seek a discount of 25 to 49 per cent off the list price of Mounjaro [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Budget impact and timeline

If public plans cover Mounjaro, the report estimates the cost at $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/]. Public plans spent $794-million on Ozempic in 2024, the most recent data cited in the report [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Mounjaro's Canadian pricing has shifted multiple times since Health Canada approval in late 2022 [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. Eli Lilly first sold it in a cheaper vial form, hiked prices in 2025 while moving patients to an injectable pen format, then cut prices by 20 per cent or more at the end of 2025 [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Manufacturer response and pending files

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 versus semaglutide 1 mg, and that the company would engage constructively with CDA as it finalizes its recommendations [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/]. CDA is still examining Eli Lilly's applications for Zepbound, which contains the same active pharmaceutical ingredient, with submissions covering two separate indications [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; the company has not said why [Source: theglobeandmail.com/business/economy/article-canada-drug-agency-mounjaro-recommendation-type-2-diabetes/].

Generic semaglutide context

The report notes that generic forms of Ozempic are currently being reviewed by Health Canada, and when those 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/]. For dosing tracking on Wegovy and Rybelsus, see our generic semaglutide tracker. Patients comparing private plan options may also consult our insurance coverage checker or FAQ.

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