A seismic shift in the global drug market has left British patients questioning why they are subsidising the profits of pharmaceutical giants while Canadians enjoy cheaper access to life-saving treatments. The arrival of generic semaglutide, the active ingredient in Ozempic, in Canada at a fraction of the UK price has reignited the debate over the nation's broken drug pricing system.
Canada’s move to license generic versions of the blockbuster diabetes drug, which also aids weight loss, will see prices drop by up to 70 per cent from the branded version. Meanwhile, UK patients face stubbornly high costs despite the NHS’s vaunted negotiating power. The Canadian model, which uses a compulsory licensing framework similar to that once employed by the UK for HIV drugs, is being hailed by campaigners as a template for reform.
The contrast is stark. In Canada, a month’s supply of generic semaglutide will cost around £150. In the UK, the branded Ozempic remains priced at over £200 per month, with the NHS footing the bill for some but not all. For those without prescriptions, private prescriptions cost even more. This is not a tale of two systems but a glimpse of what the UK has lost: the ability to put patients before patents.
“This is a scandal,” said Margaret Hodge, a retired nurse from Manchester who now campaigns for affordable medicines. “We have a drug pricing system that rewards companies for keeping prices high. The Canadian approach shows that there is another way, but our government refuses to take it. They are more worried about upsetting the pharmaceutical industry than helping people.”
The UK's current model relies on the Pharmaceutical Price Regulation Scheme (PPRS), a voluntary agreement that caps profits but does little to force down prices for individual drugs. Critics argue that this system, combined with a reluctance to use compulsory licences, has left the UK paying some of the highest prices in Europe for brand-name medicines. The result is a postcode lottery where access to treatments depends on local NHS budgets rather than clinical need.
“The UK was once a world leader in using compulsory licensing and parallel importation to keep drug costs down,” said Dr. Sarah Woolley, a health economist at the University of Sheffield. “But we have moved away from that model, partly due to pressure from the US and the pharmaceutical lobby. The Canadian move should be a wake-up call. We need to revisit that approach or risk being left behind.”
The issue hits hardest for those with long-term conditions. For type 2 diabetes patients who cannot take metformin, Ozempic can be a game-changer. But with the NHS under strain, access is often restricted. “I was told I could have it, but then the referral was rejected because my local CCG said it wasn’t cost-effective,” said John Carter, a factory worker from Leeds. “I’ve put on weight and my blood sugar is out of control. Meanwhile, my cousin in Toronto gets it cheap. It makes you angry.”
The Canadian generic approval came after a long legal battle by generic firms against Novo Nordisk, the patent holder. The UK’s patent system, while strong, has not been as aggressive in challenging secondary patents that extend monopolies. Campaigners argue that the UK Patent Office should be more proactive in scrutinising claims that keep prices high.
The Greater Manchester Combine, a coalition of trade unions and community groups, has called for the government to issue a compulsory licence for semaglutide, as it has for some cancer drugs in the past. “We cannot let patent laws stand in the way of public health,” said the group’s convener, Olivia Brennan. “If Canada can do it, why can’t we? The answer is political will, not legal barriers.”
The government defends the current system, pointing to the success of the NHS in securing discounts through volume purchasing. But as more people struggle with obesity and diabetes, the pressure is mounting. The UK’s drug bill has risen to over £20 billion a year, and much of that is spent on brand-name drugs with generic alternatives available elsewhere.
The lesson from Canada is clear: patients should not have to pay more for the same medicine simply because of where they live. The UK needs to rediscover its bite on drug pricing, or millions will continue to pay the price.
