The stark disparity in the price of the blockbuster diabetes drug Ozempic between Canada and the United States has reignited debate over pharmaceutical pricing models, with the British National Health Service’s negotiated pricing framework being hailed as a potential template for international cooperation.
Ozempic, manufactured by Novo Nordisk, costs approximately $900 per month in the United States, compared to $155 in Canada. The difference, attributed to Canada’s system of price controls and bulk purchasing, has drawn sharp attention from policymakers and health economists who argue that the current US system is unsustainable.
At the heart of the discussion is the UK’s NHS pricing mechanism, which combines value-based assessment by the National Institute for Health and Care Excellence (NICE) with collective bargaining. The model ensures that drugs like Ozempic are available at a fraction of the US cost while maintaining incentives for innovation. Analysts note that the NHS spent an average of £13 per patient per month on Ozempic in 2023, a figure that aligns closely with Canadian pricing.
“The NHS model demonstrates that it is possible to provide access to cutting-edge treatments without bankrupting the system,” said Dr. Eleanor Hartley, a health economist at the London School of Hygiene and Tropical Medicine. “It requires political will and a willingness to negotiate, but the results speak for themselves.”
The issue has gained urgency as demand for Ozempic surges, driven partly by its off-label use for weight loss. Shortages have been reported in both Canada and the UK, highlighting the fragility of global supply chains. In the US, where the drug is not covered by Medicare for weight loss, out-of-pocket costs have spurred a black market for compounded versions.
Canadian Health Minister Mark Holland recently stated that Canada’s Patented Medicine Prices Review Board is committed to maintaining affordability. “We have a system that prioritises patients over profits,” he told reporters. “The US could learn from us, but they must first address their political obstacles.”
US lawmakers have introduced legislation to allow Medicare to negotiate drug prices, but progress has been slow. The Inflation Reduction Act of 2022 granted Medicare limited negotiation powers, but the policy is phasing in gradually and does not yet apply to drugs like Ozempic.
Global health organisations have suggested that the NHS model could serve as a benchmark for a multilateral framework. The World Health Organization has called for greater transparency in pharmaceutical pricing, noting that the disparity in prices for the same drug across borders undermines trust in the system.
“The United States is the largest pharmaceutical market in the world, yet its citizens pay the highest prices,” said Dr. Thomas Chen, a health policy expert at the University of Oxford. “If the US adopted a similar approach to the UK or Canada, it could lower costs not only for its own population but set a precedent for global pricing norms.”
Critics argue that the NHS model would stifle innovation by reducing profit margins. However, proponents counter that the UK remains a leading centre for pharmaceutical research and development, with companies continuing to invest in breakthrough therapies.
For now, the contrast between Canada and the US illustrates a fundamental choice: a market-driven system that maximises shareholder value, or a regulated model that prioritises access. The British NHS offers a middle path, one that policymakers on both sides of the Atlantic are watching closely.
