UK GPs told to halt semaglutide prescribing without funding guarantee: what this signals for Canadian access

This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

A September 2026 BMJ news report revealed that the British Medical Association (BMA) has told UK general practitioners not to prescribe semaglutide (sold in Canada and the UK as Wegovy; also available as Ozempic for type 2 diabetes) for cardiovascular risk reduction unless they have a written funding guarantee from their local health authority. The directive came six months after the UK's National Institute for Health and Care Excellence (NICE) approved that specific use for adults with a body mass index of 27 or higher who had experienced a heart attack, stroke, or peripheral arterial disease. For Canadian patients, the immediate takeaway is this: Canada has not reached even the NICE stage. Health Canada has approved Wegovy only for chronic weight management, not for a cardiovascular indication, and no provincial drug plan, including OHIP in Ontario, RAMQ in Quebec, MSP in British Columbia, or AHCIP in Alberta, covers Wegovy as a routine benefit.

What this means in Canada

Health Canada approved semaglutide as Wegovy (2.4 mg weekly injection, manufactured by Novo Nordisk) in November 2021 for adults with obesity or overweight plus at least one weight-related condition. That approval was for weight management, not heart-disease prevention. As of September 2026, Health Canada has not issued a separate approval or label expansion for a cardiovascular-risk indication, and the agency has not published a timeline for reviewing one.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) has not issued a position statement specifically on GLP-1 receptor agonists for cardiovascular prevention. The Canadian Diabetes Association (now Diabetes Canada) has published guidance supporting semaglutide use in people with type 2 diabetes who have established cardiovascular disease, but that guidance applies to Ozempic (the 0.5 mg to 2 mg diabetes formulation), not to Wegovy at the higher weight-management dose.

On cost: Wegovy runs approximately CAD $350 to $450 per month at Canadian pharmacies without coverage. Provincial drug plans treat it inconsistently. Some plans cover Ozempic for type 2 diabetes with prior authorization, but Wegovy for weight management is excluded from most provincial formularies. A small number of private employer benefit plans cover it, usually with a body mass index threshold and specialist documentation. Patients accessing semaglutide through Canadian telehealth platforms such as Felix, Maple, or Science & Humans (scienceandhumans.com) still pay out of pocket unless they have private insurance that covers the drug.

What changed in the UK and why it matters

The UK sequence is instructive. NICE approved semaglutide for cardiovascular risk reduction in March 2026, citing the SELECT trial, a 17,604-participant randomized controlled trial published in the New England Journal of Medicine in 2023, which found that semaglutide 2.4 mg reduced major adverse cardiovascular events by 20 percent in people with overweight or obesity and pre-existing cardiovascular disease but without diabetes. That trial was the basis for the US Food and Drug Administration (FDA) approving Wegovy for cardiovascular risk reduction in March 2024 (FDA-approved in the US; Health Canada has not issued a parallel approval).

Despite NICE's green light, the BMA's September 2026 guidance makes clear that clinical approval and funded prescribing are two different things. UK GP practices are not automatically reimbursed for prescribing outside their contracted service scope, and the BMA told GPs that writing Wegovy prescriptions for heart health without a funding commitment exposes practices to unrecovered costs. The result is a gap between what the evidence supports, what the regulator permits, and what the system will actually pay for.

Canada has that same structural gap, just at an earlier stage. The evidence base (the SELECT trial) is the same. The regulatory approval for the cardiovascular indication does not yet exist here. And provincial pharmacare frameworks have not built a reimbursement pathway for it.

What Canadian patients should know

If you have had a heart attack, stroke, or peripheral arterial disease and also have overweight or obesity, the SELECT trial data are relevant to your care. Talk to your cardiologist or family physician about whether semaglutide at the Wegovy dose makes sense for your situation, understanding that you will likely pay out of pocket in Canada right now.

If you have type 2 diabetes with cardiovascular disease, Ozempic may already be covered under your provincial plan or private insurance, and Diabetes Canada's guidelines support its use in that context. Ask your prescriber whether the diabetes formulation applies to your case before assuming you need Wegovy.

Patients in Ontario can check the Ontario Drug Benefit (ODB) formulary directly. Quebec patients can check the RAMQ public formulary. Neither listed Wegovy as a covered benefit as of this article's publication date. British Columbia's PharmaCare and Alberta's AHCIP similarly do not list it for weight management or cardiovascular prevention.

Canadian telehealth platforms including Felix, Cleo, Maple, and Science & Humans can prescribe semaglutide where clinically appropriate, but they cannot change what provincial drug plans reimburse. Patients using these services pay the full pharmacy cost.

Provincial differences matter for one other reason: compounded semaglutide. Health Canada has not authorized compounded versions of semaglutide, unlike the US where some compounding pharmacies filled prescriptions during a shortage period. Canadian patients should be cautious about any product marketed as compounded semaglutide; it does not have Health Canada authorization.

Limitations and open questions

The BMJ report is a news item, not a clinical study, and the full BMA guidance document was not publicly available at time of publication. The SELECT trial, while large and well-designed, enrolled a specific population (overweight or obese adults with pre-existing cardiovascular disease, no diabetes) and its findings do not automatically extend to other groups.

Health Canada has not announced whether it is reviewing a cardiovascular-risk application for Wegovy. The SOGC has not weighed in. The Canadian Cardiovascular Society has not published a formal position on GLP-1 agonists for primary or secondary cardiovascular prevention as of September 2026. What the UK situation shows is that regulatory approval, when it comes, does not guarantee funded access. Canada's provinces would each need to add Wegovy to their formularies independently, a process that typically takes one to three years after Health Canada approval and involves the Canadian Drug Review process at the Canadian Drug Agency (formerly CADTH).

For now, Canadian patients with cardiovascular risk factors and obesity should raise the SELECT trial data with their physicians and ask directly whether any coverage pathway exists for their situation. The evidence is there. The access is not.

This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

Editorial note

Hormone Journal articles are written by our editorial team and reviewed against published clinical guidelines, with a focus on Canadian patient access. We do not promote specific clinics or providers.