Zepbound (Tirzepatide) now available in Canada
The long awaited approval of tirzepatide for weight management (Zepbound) in Canada has arrived, as of today patients no longer have to use Mounjaro off label for weight management if they wish to use the medication tirzepatide for weight management purposes.
Tirzepatide, which has been approved in Canada as a diabetes medication (Mounjaro) since 2022, received Health Canada approval for obesity recently, but was not available in pharmacies until now. (Note that in some countries, tirzepatide is under the brand name Mounjaro whether it’s for diabetes or for obesity. In countries like USA and Canada, it’s called Mounjaro for diabetes, and Zepbound for obesity.)
What Zepbound Brings to the Table
For patients living with weight, average weight-loss in the SURMOUNT trial (72 weeks at full dose) was 20.9 % (≈50 lb), making it the strongest and most effective medication for weight management available in Canada at the time of this post.
It has additional benefits that go beyond weight, such as improvements in blood sugar, blood pressure, sleep-apnea, MASLD (formerly fatty-liver disease), and HFpEF (Heart Failure).
Tirzepatide is a dual incretin medication, meaning it works by interacting with 2 different hormone receptors, vs semaglutide (Ozempic, Wegovy) works through only the GLP-1 receptor. With future tripple agonist medicines like retatrutide leading to even more weight reduction than Tirzepatide, it looks like weight medications with multiple mechanisms lead to more efficacy. This makes sense when you understand ABCD obesity to have multiple genetic underpinnings.
How Much Will It Cost?
Lilly has confirmed that they will not levy a tax on fat by making Zepbound more expensive than Mounjaro - a smart decision. Lilly has launched the myZepbound.ca financial assistance:
Pen strength List price / month
2.5 mg or 5 mg CAD $378.00
7.5 mg or 10 mg CAD $529.20
12.5 mg or 15 mg CAD $756.00
myZepbound highlights (so far):
Financial assistance regardless of insurance status (details TBA).
Cash-paying patients: 1 free month for every 6 consecutive months—an extra ~14 % discount.
Program should be live now.
2nd Generation of Weight Loss Medications
Zepbound joins Wegovy in what some people refer to as the second generation of weight loss medications. It’s a new generation because prior medications did not reliably get past 10% unless augmented with intensive behaviour therapy and/ or medical meal replacements like Optifast. Getting past 10% weight reduction reliably, and especially getting past 15% seems to be the threshold where we start to see a more signficant and widespread health benefit from weight management. With Zepbound (tirzepatide) achieving 15–21 % and Wegovy (semaglutide 2.4 mg) achieving 10–15%, patients may see reversal of diabetes, hypertension or sleep apnea. A patient being able to stop using their CPAP machine to help them sleep - that’s not just a health benefit, that’s a life benefit. This is truly a new generation. When combined with intensive behaviour therapies and multimodal treatment, the improvements in health can be even more exciting, as medication can often be the added tool that helps patients engage and adhere to lifestyle changes like increases in physical activity or changes in nutrition.
Get Treatment from a Professional
As effective as these medications are, 1 in 5 patients are still being treated at the 1 year mark. Seeing an ABCD/ Obesity/ weight professional for comprehensive assessment and management can help you engage therapy feeling confident, fully informed and set up for longer term success. Weight management is long term, it’s not a quick fix deal - find a professional who can confidently manage you now as well as walk with you for the long term.
Dr Ryan Oughtred, ND, is a CBE/ Weight loss doctor located in Vancouver, Whistler and Sea to Sky.