Need to know: dosing confusion on First Generic Wegovy approved in canada

Hot on the heels of the first generic Ozempics (semaglutide for type 2 diabetes), the first generic Wegovy (semaglutide for weight management), called Sevmia, has now been approved by Health Canada.

The Sevmia product monograph provides dosing guidance to reach ‘the therapeutic and maintenance dose’ of 2.4mg weekly, which mirrors the approval and maximum dose for branded Wegovy. However, where it gets confusing is that the Sevmia product monograph also says that it “can be prescribed only for 1mg once weekly dosing. Alternative products are needed to achieve doses of semaglutide injection exclusive of the 1mg dose”. Sevmia appears to only be approved in the 1mg dose pen, which is likely the reason for this guidance.

Also, while Sevmia is approved for weight management and to reduce the risk of cardiovascular events (same as branded Wegovy), it is missing the approval for improvement in MASH (‘fatty liver’) that Wegovy carries. So, if a private insurance company picks up Sevmia, it may not cover it for improvement in MASH. As Sevmia is generic semaglutide, the health benefits are expected to be similar to branded Wegovy, including benefits to MASH.

Different people need different doses of weight management medication, and as per our Obesity Canada Guidelines (on which I am the lead author), these medicines should be titrated (adjusted) for each person as needed, as appropriate, and as tolerated to achieve health goals. However, for people needing more than 1mg, that means injecting generic Sevmia more than once per weekly dosage (up to 3 pokes if taking the full 2.4mg dose), and that will come at a higher financial cost. How much Sevmia is going to cost for the 1mg dose, and whether they will build this limitation into their price, is not yet known.

More generic Wegovy options are expected to come to Canada soon as well. Stay tuned!

Disclaimer: I am/have been an investigator in clinical trials of Wegovy. I receive honoraria as a continuing medical education speaker and consultant from the makers of Wegovy (Novo Nordisk).

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