'People who only use the drugs, without a diet and without exercise, gain weight a lot faster if the medication is stopped' argues Frances Lehun
Each month at BPM, we offer a slate of articles and content pieces that go deep on a particular topic. This January, we’re exploring GLP-1 and weight management coverage in benefits plans.
The arrival of generic Ozempic in 2026 has notably dominated conversations in the group benefits space. With Health Canada reviewing nine generic versions of the popular GLP-1 medication, the market is poised for a shift in the coming months.
But the drugs employers can access right now and how they structure their benefits will determine whether they're ready when that shift arrives.
Frances Lehun, pharmacist at Beneva, believes GLP-1 medications will remain a dominant force in the benefits landscape, even as generics are expected to arrive this year. After all, plan sponsors have several branded medications to choose from already - Contrave, Saxenda, Wegovy, and Xenical among them. But Lehun stresses that pharmaceuticals represent only one piece of the puzzle.
She underscored weight management and diabetes care have to extend beyond medication to include nutrition support and physical activity, especially given the high rate of comorbid conditions tied to diabetes. She stresses that plan sponsors need to stay continuously informed through real data, health reports, conferences, and events with clinical experts.
"We really think that GLP-1s are not going anywhere in the forecast, for this year and probably the coming year," she says. “But the drugs are not a magic solution, and we know that people who only use the drugs, without a diet and without exercise gain weight gain a lot faster than people who include this if the medication is stopped.”
Meanwhile, oral options for GLP-1 therapy remain limited in Canada. Rybelsus, a pill for diabetes, is already on the market, but no pill-based GLP-1 exists for weight management. The FDA approved an oral version of Wegovy in December, though Lehun hasn't seen any Health Canada submissions yet. And she argues patients would rather swallow a daily pill than inject themselves weekly.
"There’s a stigma around injectables and people don't like inject themselves if they don't have to. Why would you do an injection every week when you can take a pill once a day?" said Lehun, adding that formulations also come with new price tags.
"Usually, when new formulation come, new therapies come and new innovation costs come," Lehun noted.
With Health Canada reviewing nine generic versions, plan sponsors can expect significant cost reductions, which may shift employer attitudes. Beneva's internal data shows the average annual Wegovy claim runs around $7,000. And with generics delivering 65 per cent savings, that figure could fall to roughly $2,450.
While the lower threshold may convince plan sponsors who previously balked at coverage to reconsider their position, she cautions that lower per-person costs won't necessarily translate to lower overall spending.
From her vantage point reviewing prior authorizations, she notes the impact of these treatments is often much clearer to clinicians than to decision-makers who only see cost lines. That gap, in her view, is where insurers and health professionals need to step up: by sharing outcomes data, surfacing trends in the claims experience, and bringing in patient voices so sponsors understand not just what they are covering, but the real-world benefits those decisions can deliver.
The implications are also complex as new indications for GLP-1s are expected, the prevalence of diabetes and obesity continues to rise, and more affordable pricing could drive utilization upward. Diabetes consistently ranks among the top three medical conditions in claims data, while obesity medications are trending higher. Generics may slow the growth rate, but they won't reverse it.
“It's really important to look at it and analyze it and see how we can manage it because diabetes is always one of the top three classes of medical conditions and we know that medication for obesity is trending upwards also. So you have to take both considerations. The cost per person will be lower, but the trend and the uptake can increase,” noted Lehun.
Patient skepticism also poses a real barrier to generic adoption. Lehun says some people fear generics aren't equivalent to brand-name medications, but Health Canada's approval process demands proof of the delivery of the same safety, efficacy, and clinical effect. "Some people are scared of generics, right? They think it's not the same," she said, adding that misconception requires direct communication from plan sponsors and pharmacists.
Another stumbling block involves the switching process itself. Many patients assume they need a new prescription from their doctor to move to a generic but Lehun underscores they don't as pharmacists can make the interchange directly. The injectable devices may look different, but pharmacists can walk patients through any changes. She maintains side effects won't differ either.
"It's the same molecule, so it should be the same as your Ozempic and as your Wegovy, so both of them will have the same side effect," said Lehun.
