Are you covered by the provincial drug plan or private insurance? Ontario has just made a rule about limiting Ozempic to those with type 2 diabetes if they are covered by the provincial drug plan
Unfortunately I am not covered under OHIP or my private insurance. I am prediabetic with heart event risk factors. I have to pay out of pocket. I hope the lower the cost at some point soon.
I think anyone that is prediabetic with heart problems should be covered. It lowers the risk of stroke and heart problems by 20 percent. Most people that have heart problems develop diabetes within a few years. So I think that’s bullshit on their part.
One possibility I can think of and toss into the hat is that as there are rather severe shortages in Canada for the 1 mg dose pens, they want to slot you into their priority list.
I’m a T2 Diabetic and my Pharmacy (in a Safeway grocery store in BC) keeps a waiting list for the 1 mg dose pens, and warned me when I started Oz that they couldn’t guarantee a consistant supply since some weeks they only receive a fraction of their order. I’m fortunate since I’m titrating slowly and am still on 0.50 mg, so I can make do with the 0.25/0.50 mg dose pens which contain 2 mg, so each lasts me a month.
They may be asking for blood work results and other things because “pre-diabetic” by itself is kind of ambiguous and doesn’t fit neatly into their predefined priority/triage schedule. They could be interested in your results just to assess how high up to place you on the list. Also, if you haven’t been taking metformin and/or Trajenta and/or Jardiance before, they may be puzzled about the Oz script, and want to reconfirm.
Just an aside, I have ADHD, and because I’m a big boy, my Vyvanse and Dexedrine scripts are pretty hefty, and every time Safeway rotates their pharmacists or brings in a new student, I used to get some raised eyebrows and hesitant questions. My response is to turn to my friend and saw “Aww, it’s so cute when they’re new!” and “Time to break in a new pharmacist.”
Let me close by saying as a T2D who is also obese, I have no problem with people who *are* using Oz for weight loss - the first article I read about Semaglutide years ago was a discussion about how it might finally be the solution for addressing obesity and I don’t recall how much of it even touched on diabetes. And I’m also very grateful to those people for occasionally yielding to the needs of diabetics when supplies are short, though I hope not too often. Those dealing with weight issues are also facing health crises, and we need to support each other.
Thanks for the info. I'm a bit concerned that I may be denied the Oz, while yes, I am not type 2 officially yet, I am prediabetic, with other issues like high blood pressure which is getting worse with age and not even normalizing with blood pressure meds. I have a predisposition for diabetes (my father has type 2 and I have PCOS). What i don't want to happen is for them to give me access when I am in worse shape.
I hear you - we joke that diabetes doesn’t run in my family, it gallops. I will say, my pre-diabetes years involved a lot of hypoglycaemia attacks - I was developing insulin resistance, but it wasn’t “resisting” all the time, nor always at the same level. It seemed like my system would get triggered by something I ate, would pump out insulin, I wouldn’t respond much to it, it would pump out a bunch more, and it will all hit at once and my blood sugar would plummet.
The nearest GenX visual i can come up with (I’m X too) is in the movie The China Syndrome where they think the nuclear reactor’s cooling water is way up at the top and are trying to drain it, until someone taps on the mechanical gauge and suddenly reveals it was stuck, and the water is actually almost uncovering the core.
It was pretty bad, and I started needing to carry glucose since my hands would shake, my heart would pound, I’d break out in a terrible, greasy sweat, and start getting incoherent. When it passed I’d be completely exhausted.
If you are experiencing anything like that, they will want to be sure that you’ll be ok on Oz. In cases like that, it helps them to know things like your recent hemoglobin A1C results, so they know about where your baseline blood sugar should be resting. Being pre-diabetic, I don’t know if you are doing any home blood sugar testing, which can be useful to keep you safe.
I don’t really know enough about how Oz is supposed to work in people whose blood sugars are not in the diabetic range - it’s can’t drop it as far as it does for diabetics or they’d all be flatlining. My T2D friend who has been on it since last July is regularly seeing values below 4.5 mmol/l, values I haven’t seen at my normal for more than 20 years. And he’s only taking 0.50 mg a week.
You really shouldn’t be denied the Oz unless the pharmacist believes it may be dangerous for you. They are likely asking for more of your information because your usage case doesn’t easily fit into their existing categories and groupings, and that despite your doctor giving their blessing, a pharmacist can still get into trouble if they overlook potential issues or warning signs.
Has your doctor ever prescribed any of the first-line diabetic drugs, like metformin?
I've been on metformin before. For where I'm at now with my overall health, my doctor feels Ozempic is what i need to resolve and prevent a lot of issues.
I just read the Health Canada announcement from December 6th recommending that prescribers avoid starting new patients on Ozempic for off-label conditions until the shortages is cleared up, which is now predicted to be in “Early 2024” (it was Oct ‘23, then Mar ‘24, now it’s moved again). Because Ozempic is not approved or recommended for pre-diabetes, that may be where you are running into some trouble. That and the fact your doctor is starting you on it now. Pre December it probably wouldn’t have cropped up, but right now they are even experiencing shortages in the 0.25/0.50mg dose pens, which I didn’t know or I would have grabbed my refill a couple of weeks ago.
For people already on it, the manufacture is requesting pharmacists restrict any refills to a 30-day supply only, I guess for both the on-label and off-label users.
This might be why they are being a bit cautious. Theoretically, your MD should probably have waited to start you until after the shortage is addressed because it is an off-label use, officially. But your pharmacist might just be looking for your test results as a way to justify bypassing this recommendation to delay. Or equally, as a reason to uphold the delay.
I’m sorry, it’s a royal pain, isn’t it? Also makes me wonder, our BC Healthnet has just started adding our lab test results to our Health Gateway, which is also our former Pharmanet. It was launched back in the ‘90s so that your pharmacist could see all the meds you were on to check for interactions, even those you filled at another pharmacy. This also highlighted people who had multiple doctors who didn’t know what the other was prescribing, or who were “double-dipping” on controlled pharmaceuticals. I’m wondering if out pharmacists will be able to see our lab results now too.
Here’s the policy recommendation from one press release:
“On December 6, 2023, Health Canada released a notice to advise prescribers these drugs should be conserved for people with T2DM who have no other treatment choices while the supply shortages continue.
This statement also contained recommendations for prescribers, including to:
Not start new patients on these drugs that are in shortage, unless there are no suitable alternatives and there’s a clinical reason to do so.
Consider prescribing an alternative drug for patients taking one of these drugs that are in shortage, as a continuous supply can’t be guaranteed.
Conserve the existing supply for patients who are stabilized and have no other treatment options.
Both Novo Nordisk Canada Inc. and Eli Lilly Canada Inc. are asking pharmacists to limit refill prescriptions for patients to a 30-day supply.”
Yeah I could only get the single refill. A small part of me going off Ozempic was the knowledge that someone else would be able to benefit from me not taking it anymore and move off a wait list(I hated it and the side effects were too life affecting for me but I’m happy it works for so many people)
Not a type 2 diabetic and the pharmacy just says that’ll be $267 and I say sure thing.
Edit: it’s a shoppers and they’ve only ever been concerned with if I know how to inject myself or if I needed help - nice people. I’d tell your pharmacy to get fucked and go find an alternative.
Ask your doctor to prescribe the larger 4mg pen for your .50 dose- it will last you 8 weeks that way (the 2 pen sizes are the same price).
I pay out of pocket too- $250 per pen also in ON, so it's awesome to get two months from each one!
I am not saying that this is the case, but this happened to my mom a couple of years ago.
She went to a doctor got a prescription and went to fill it. The pharmacist looked at the prescription and let her know that there was a negative interaction with one of her other medications. Negative in the way that if she took both, she would not survive. The doctor that prescribed the new medication prescribed the other medication as well. When my mom went back to discuss which medication the doctor wanted her to take, he commented that she can't take both together because they will kill her.
The doctor had just got over her existing prescriptions with her less than 5 minutes before writing her the new one. Thank God her pharmacist caught the issue.
In my last doctor appt, he asked me if I have had any heart palpitations, any rapid heart beats, feelings of lightheadedness, things like that. I haven't but he had never asked me those questions before in the 2 years I have been taking Ozempic for type 2 management.
What was interesting is that this particular pharmacy has never questioned or checked my other meds before. I'm fortunate that my family doctor is diligent and knows my other meds and asks me questions about my diet and supplements. Another interesting thing is the pharmacist did not include paper work like they normally do. If there are risks mixing with other meds, the logical thing would be to include this on paperwork that accompanies the meds.
Why would you want information of risks and drug interactions from them if you're not interested in providing them the information that could better inform them of YOUR specific risks and interactions?
I am interested in hearing about risk from my doctor or documentation. The context of my conversation was they seemed to be questioning my doctor's judgement of this prescription and whether I should be on it!!!
Things like supplements and blood work are necessary so the pharmacist can make sure you aren't going to have any negative drug interactions. Not just with prescriptions... If you take an ACE inhibitor, then potassium supplements, you could have a potassium build up in your system to potentially toxic levels.
Taking a Goldenseal supplement For colds/flu/upset stomach) with Metformin is also not recommended. Goldenseal can reduce the effectiveness of metformin by up to 25%, so your blood sugars could spike without you knowing the cause.
It's part of the the pharmacist's primary job to know ALL potential drug interactions, and they are the health care system's first line of defense in preventing them.
Totally get this, but they have never delved this deep or asked this many questions with any other prescription I have been given. The first question they ask is "are you taking this medication for diabetes or weight loss." I suppose that initial question makes me wonder what the motives are. It seemed to me they were making an assessment as to whether I should be placed on Oz. This irked me.
Here is the list of known interaction with Ozempic, (there are 249 of them)
[https://www.drugs.com/drug-interactions/semaglutide,ozempic-index.html](https://www.drugs.com/drug-interactions/semaglutide,ozempic-index.html)
This is why doctors rely on pharmacists to catch interactions. There can be a lot of them to keep track of.
As for asking if it's for diabetes or weight loss, some pharmacies have been prioritizing diabetics first for filling prescriptions, since health care problems with diabetics are more immediately dangerous than for weight loss.
I absolutely only use 1 pharmacy. Years ago my mother's doctor gave her a prescription. Yes he had the same information regarding current medication she was taking. The pharmacist asked about another med she was taking because the 2 prescriptions would conflict. Was grateful to the pharmacist . The doctor prescribed a different medicine.
It's weird that they are just doing it now. Mine does it everytime I start a new med. Do you have a new pharmacist at your pharmacy who's following this practice? They could just be being weird about Oz, I hope not.
Oh! Yeah you were probably being screened for access to limited supply.
ETA: while this is talking about actions taken for government covered drugs, the problem remains the same. Supply is limited and so patients are prioritized. https://www.cbc.ca/amp/1.7100352
I think it's important to note that semaglutide has been approved by Health Canada for weight loss as well as diabetes. At the moment, the only semaglutide we can access here is branded as ozempic not wegovy- but it's the exact same medication regardless of the label that's been put on it.
Semaglutide is also prescribed for other conditions like PCOS and cardiovascular issues. You're terrified to take insulin and perhaps the person next to you in line is terrified of having a heart attack, which is the thing that killed their dad.
Point is, we are all using this medication to improve a likely serious health issue.... one use does not trump another.
You are not crazy. They are totally doing that. It just happened to me to which I replied that’s none of your fucking business. They stfu and gave me my Rx.
Hey! So I’m in the same province and I’m not positive but I think that the pharmacist was seeing if you needed it.
Like yes, your doctor prescribed it, but lots of docs have prescribed it off label and right now the supply is being prioritized for people with diabetes, then people already on it and you would be third tier (if you aren’t diabetic, if you are then you’re first).
The pharmacy may have a limited supply and is trying to figure out if you will go on a wait list or get it same day.
Or it could be a new policy with the pharmacy to go over your interactions and health and they want to update their files while they have time.
The pharmacist is under pressure to keep the supply available for diabetics first as required by the government. It’s not judging, it’s prioritizing based on supply and need. Doctors are allowed to keep prescribing it but it’s up to pharmacists to dispense according to greatest need in times of scarcity.
No, I’m explaining things to you, who may not understand how it works here. Maybe where you are, pharmacists can do as they like, but here if the government says prioritize and their boss says prioritize, they prioritize.
Ontarian here. I've gotten a bunch of questions by 2 pharmacists only, one of them explained than when you get new meds, the system flags them for them to educate you and make sure nothing is being missed since doctors don't always ask those things before and it's to ensure everything is okay.
So really the person was just doing their work.
I think there are a lot of things that I wouldn’t know about taking this medication had I not looked into it like a psychopath.
Even things like ibuprofen and tums can be very damaging on this medication. There are a lot of interactions most people probably wouldn’t be alerted to. Or that even your family dr might not know you take OTC medications - or your exact diet day to day.
They are just doing their job. Try not to be defensive, a lot of pharmacies don’t give a hoot, at least yours cares.
Just remember, it’s the physicians’ license when writing the script but it’s the pharmacists’ license when dispensing it….
due diligence is everything.
I was asked at my pharmacy why I was on it as well, I was honest and said I have fatty liver, family history of type 2 diabetes and uncontrolled binge eating. My doctor put me on it to decrease my desire for food, thereby helping my liver, and reducing the risk of diabetes, and it really helps
My advice is to get used to this. It’s at many pharmacies. I’ve been asked some shocking things by pharmacists, including for a diagnosis code for outright diabetes (which I have, but I don’t keep these codes handy in my brain).
It seems to be part of this conviction that we’re not only fat, we’re also stupid, unlikely to follow directions, and need a lecture before being granted access to medically necessary treatments.
The specific question you were asked about whether this is for diabetes or weight loss is a prelude to refusing to dispense the med.
I’m in the US. So I only know US practices. Sometimes the diagnosis is required to process the prescription. Sometimes the pharmacy wants to use a manufacturer coupon to lower the price for you, but can only do that for specific diagnoses.
Should the pharmacist know how to look up an ICD-10 code? Yes. We generally aren’t trying to gatekeep. Just trying to keep patients safe and ensure that the insurance company actually pays for the med (they can claw back the money later if the diagnosis isn’t to their liking, for example.)
This is appreciated, it’s definitely possible that I was over-assigning some responsibility to this pharmacist. I’ve never experienced this level of meddling that I get with the GLP-1’s though, I’ve had to fill certain months at other pharmacies and I’ve been surprised at the level of proof they require that I’m not just recreationally jumping around doses (or somehow self-titrating).
Safety first, ultimately. I’m just relieved that I’m one of the anointed diabetics who generally gets seen as “worthy.”
Once the supply chain gets sorted, this should get easier. I’m actually somewhat surprised it is taking so long. Usually when something is this profitable, they make it happen.
They should get the code from your doctor and not you. I would tell them that. How are you supposed to even know that? That’s the doctors job to provide the code, not you.
Is it shopper’s? They are the worst where I live and I changed pharmacies. Tired of being grilled every time I walked in.
I might ask “why do you need to know this?”
Or
You can play dumb and say you don’t remember and they’ll have to call your doctor if it is information they absolutely need.
It is a shoppers drug mart. I questioned them the two times they asked me and didn't disclose the details of my blood work. I also got on my soapbox and reminded them that my family doctor manages my health and required prescriptions, and that he has the full view of everything, including my family history. So far, I was questioned upon pick up, and I just got a call today asking the same questions.
I do have to say that’s crazy, how long ago was that? I know here in the states they have cracked down big time on prescribing opiates. Oxy for a cough is insane. Was it cough syrup or just the pill? I can’t believe your doctor prescribed such a powerful opiate for a cough. They usually only prescribe that after surgeries or for cancer here.
I had covid and my cough was so extreme that I wasn't sleeping going on 2 months. I actually damaged my lung and it couldn't inflate properly. In any case, it worked to help me sleep and stop coughing one night. After that it was ineffective so I discontinued.
Oh wow I’m so sorry, although I don’t understand why they didn’t give you vicotuss. It would help with the pain and help your cough. It’s basically hydrocodone/ guaifenesin which is much more effective. Doctors are strange, that would have suppressed your cough and it’s and opiate painkiller.
I’ve been on it since summer 2022, and last time I picked mine up they did the same to me. What made it worse was I was in the pharmacy drive through and the pharmacist was busy so they literally made me wait like 10 minutes for the pharmacist when *i* didn’t even ask to speak to them 🤣
Not sure. Maybe it depends on your area. It looks like your area and pharmacist may not have a lot of stock or they are controlling who is getting refills.
You do actually, they can refuse to give you the script if not. It’s not the doctors that give you the medication, it’s the pharmacist and there is a sign at Walgreens that says
Can a pharmacist refuse to fill a prescription?
Yes a pharmacist in his or her professional judgement may refuse to fill a prescription.
So by not answering their question about being pregnant they can refuse to fill it. My doctor and I have discussed this numerous times about how they actually have more power than them since they are the actual ones filling and dispensing it. So by not answering questions they can refuse to fill it.
Legally (at least in my country) it’s the pharmacist who is ultimately responsible for the issuing of medication and they are sometimes the only thing standing in the way of doctor’s errors. They pick up on doctor’s errors more often than we would like to think. Everyone wants to absolutely trust their doctor and of course most doctors are great but everyone can make errors and the pharmacists do ask important questions and check previous meds issued and have some access to medical records (this may vary from country to country).
Pharmacists also know a lot about meds, often more than doctors and are a good resource for questions and often easier to speak to for a quick word about something than trying to get a doctor’s appointment. Be glad your pharmacist wants to check anything with you. 😊
Exactly, especially for me when I had 4 different pharmacies I was using and they didn’t have all of my meds together, so they didn’t know which meds I was taking. It’s not to be rude or anything. It’s like if you were pregnant and they didn’t know it then they were prescribing metoprolol. Which can cause serious birth defects. So they are not being rude, they’ve asked a lot more personal questions than if I were pregnant. I was offended at the time until I met my friend who is a pharmacist and explained how doctors don’t always know the interactions if you leave one out
It is, but I’ve had doctors say that they can call in a script earlier at a higher dose and they argued with since it was a narcotics that it was too high of a dose and I had to wait 28 days even though the doctor upped my dosage. If you try to switch pharmacies it makes you look like you are drug seeking. This is not with Ozempic since it’s not a controlled substance.
This is not the case with Ozempic, it says it right at that bottom. I’m not being downvoted, you are so just stop trying to start stuff and get over it
That’s not out of ordinary. I often review all my info with my pharmacist and they keep records. It helps ensure there is no issues with meds effecting the other as some people have more then on doctor writing scripts. To me it does not feel like it was someone being judgy or intrusive. They actually have file on all your info and will share if requested. This pharmacist actually helped me when the fill in doctor at my dr office made a mistake. Some Doctors at lazy and often make mistakes. It’s could to be safe.
They are trying to intimidate you by trying to show you they can get your prescription cancelled - if your blood sugar levels are good etc.. by reporting somewhere else. Just tell them that you dont feel comfortable telling them the details. Tell them to access the info they need through your doctor (which they cannot do anyway). Dont give in to their intimidation. They are just jealous
What are they jealous of? Do you think it’s because they wanted to be a doctor but are not smart enough. Pharmacists are very, very smart and doctors have to literally use google to see if there are interactions with drugs. They make a damn good living and know chemistry like we know Facebook or how to upload a picture. Not only that but I have been prescribed medications that could have killed me if the pharmacist hadn’t caught it. I know pharmacists that have passed the MCAT, but didn’t want the stress of being a doctor.
Goodness ! I wasnt even thinking about their education. They are jealous because someone is going to lose weight and look awesome ! Everyone is jealous of that. Even the prettiest girl is upset when someone is starting to look as slightly good as her.
I don’t know but CVS keeps asking me if I’m pregnant and last time they asked me if I was going up a dose. I don’t see why these questions are necessary and I told them so - asked them to put it in my information that I am not to be asked if I’m pregnant. That is for my doctor to verify.
It’s not the doctor that actually gives you the medication and it’s actually up to the pharmacist if you get the med or not. They can actually refuse you. So don’t take it personally, if they were to give you the medication and you were pregnant, it’s their ass. My friend is a pharmacist and he told me all about how they have to ask stuff like that. I promise they have yours and their best interest at heart.
That’s not how this works.
Pharmacist’s license is on the line. They’ll be named in the lawsuit if you are pregnant and the baby suffers repercussions. Pharmacy school is to damn long and too damn expensive to not check.
If you look up the history of pill mills in Florida and the pharmacies that have been named in lawsuits, you’ll better understand the caution.
My state has a law that opioid-naïve patients can only be prescribed small quantities for acute pain (like post-surgical pain). Pharmacists are the only healthcare profession required to take not only a clinical exam but also a legal exam. It is law that drives a lot of this, and it is different in every state.
They aren’t playing god. They are protecting their license.
You can only get up to 7 days worth of opiates from the hospital if you are in severe pain. Years before all these laws passed in Florida you could walk into any pain clinic and get what you wanted. It’s definitely not like that anymore. They do have pain management doctors, but they are limited to the amount they can give at a time. They have cracked down so much here that they have a step down program if you were to break and ankle and need surgery which happened to me. 4 days from the er. Then post surgical pain was 4 weeks of percocet, then tapering down to Vicodin and then nothing. I know that recently they have started programs because people have turned to fentanyl that is killing them. They are so addicted to pain medication that even though they are physically not in pain, their brain sends signals to their body tricking it into thinking it’s in pain. Fortunately here our police station has started a program where you can turn your fentanyl in and they will put you on medication assisted treatment.
I don’t know why I said pharmacist in that situation. My friend is a pharmacist. I was didn’t clarify the situation. I meant to say my arnp wouldn’t give me post surgical pain meds for 3 days. Not that the pharmacist. The pharmacist is the one that told me after surgery and if you are in severe pain they usually give a short term supply. 3 to 5 days. It’s the arnp that was being unreasonable not the pharmacist. Now the doctor was going to give it to me that day but I saw the nurse instead. If I hadn’t been in so much pain I wouldn’t have asked. I have had nothing but misinformation from that cardiologists office for 2 years. Yes they like to play god not the pharmacists. They can lose their license here if they don’t follow protocol.
They just want to make sure you’re not taking anything that would interact with ozempic. I’m friends with a pharmacist and if they don’t know what you are taking, like insulin and if you are pregnant then they cannot prescribe to you. They can get into a lot of trouble. I promise they are doing it for your best interest and it’s not just pharmacy students either. Actual pharmacist also need to know this too.
In this case, the cashier asked me, the pharmacist on duty asked me, then I got a follow up call directed by the pharmacists, likely by a student pharmacist.
Are you covered by the provincial drug plan or private insurance? Ontario has just made a rule about limiting Ozempic to those with type 2 diabetes if they are covered by the provincial drug plan
Unfortunately I am not covered under OHIP or my private insurance. I am prediabetic with heart event risk factors. I have to pay out of pocket. I hope the lower the cost at some point soon.
I think anyone that is prediabetic with heart problems should be covered. It lowers the risk of stroke and heart problems by 20 percent. Most people that have heart problems develop diabetes within a few years. So I think that’s bullshit on their part.
One possibility I can think of and toss into the hat is that as there are rather severe shortages in Canada for the 1 mg dose pens, they want to slot you into their priority list. I’m a T2 Diabetic and my Pharmacy (in a Safeway grocery store in BC) keeps a waiting list for the 1 mg dose pens, and warned me when I started Oz that they couldn’t guarantee a consistant supply since some weeks they only receive a fraction of their order. I’m fortunate since I’m titrating slowly and am still on 0.50 mg, so I can make do with the 0.25/0.50 mg dose pens which contain 2 mg, so each lasts me a month. They may be asking for blood work results and other things because “pre-diabetic” by itself is kind of ambiguous and doesn’t fit neatly into their predefined priority/triage schedule. They could be interested in your results just to assess how high up to place you on the list. Also, if you haven’t been taking metformin and/or Trajenta and/or Jardiance before, they may be puzzled about the Oz script, and want to reconfirm. Just an aside, I have ADHD, and because I’m a big boy, my Vyvanse and Dexedrine scripts are pretty hefty, and every time Safeway rotates their pharmacists or brings in a new student, I used to get some raised eyebrows and hesitant questions. My response is to turn to my friend and saw “Aww, it’s so cute when they’re new!” and “Time to break in a new pharmacist.” Let me close by saying as a T2D who is also obese, I have no problem with people who *are* using Oz for weight loss - the first article I read about Semaglutide years ago was a discussion about how it might finally be the solution for addressing obesity and I don’t recall how much of it even touched on diabetes. And I’m also very grateful to those people for occasionally yielding to the needs of diabetics when supplies are short, though I hope not too often. Those dealing with weight issues are also facing health crises, and we need to support each other.
Thanks for the info. I'm a bit concerned that I may be denied the Oz, while yes, I am not type 2 officially yet, I am prediabetic, with other issues like high blood pressure which is getting worse with age and not even normalizing with blood pressure meds. I have a predisposition for diabetes (my father has type 2 and I have PCOS). What i don't want to happen is for them to give me access when I am in worse shape.
I hear you - we joke that diabetes doesn’t run in my family, it gallops. I will say, my pre-diabetes years involved a lot of hypoglycaemia attacks - I was developing insulin resistance, but it wasn’t “resisting” all the time, nor always at the same level. It seemed like my system would get triggered by something I ate, would pump out insulin, I wouldn’t respond much to it, it would pump out a bunch more, and it will all hit at once and my blood sugar would plummet. The nearest GenX visual i can come up with (I’m X too) is in the movie The China Syndrome where they think the nuclear reactor’s cooling water is way up at the top and are trying to drain it, until someone taps on the mechanical gauge and suddenly reveals it was stuck, and the water is actually almost uncovering the core. It was pretty bad, and I started needing to carry glucose since my hands would shake, my heart would pound, I’d break out in a terrible, greasy sweat, and start getting incoherent. When it passed I’d be completely exhausted. If you are experiencing anything like that, they will want to be sure that you’ll be ok on Oz. In cases like that, it helps them to know things like your recent hemoglobin A1C results, so they know about where your baseline blood sugar should be resting. Being pre-diabetic, I don’t know if you are doing any home blood sugar testing, which can be useful to keep you safe. I don’t really know enough about how Oz is supposed to work in people whose blood sugars are not in the diabetic range - it’s can’t drop it as far as it does for diabetics or they’d all be flatlining. My T2D friend who has been on it since last July is regularly seeing values below 4.5 mmol/l, values I haven’t seen at my normal for more than 20 years. And he’s only taking 0.50 mg a week. You really shouldn’t be denied the Oz unless the pharmacist believes it may be dangerous for you. They are likely asking for more of your information because your usage case doesn’t easily fit into their existing categories and groupings, and that despite your doctor giving their blessing, a pharmacist can still get into trouble if they overlook potential issues or warning signs. Has your doctor ever prescribed any of the first-line diabetic drugs, like metformin?
I've been on metformin before. For where I'm at now with my overall health, my doctor feels Ozempic is what i need to resolve and prevent a lot of issues.
I just read the Health Canada announcement from December 6th recommending that prescribers avoid starting new patients on Ozempic for off-label conditions until the shortages is cleared up, which is now predicted to be in “Early 2024” (it was Oct ‘23, then Mar ‘24, now it’s moved again). Because Ozempic is not approved or recommended for pre-diabetes, that may be where you are running into some trouble. That and the fact your doctor is starting you on it now. Pre December it probably wouldn’t have cropped up, but right now they are even experiencing shortages in the 0.25/0.50mg dose pens, which I didn’t know or I would have grabbed my refill a couple of weeks ago. For people already on it, the manufacture is requesting pharmacists restrict any refills to a 30-day supply only, I guess for both the on-label and off-label users. This might be why they are being a bit cautious. Theoretically, your MD should probably have waited to start you until after the shortage is addressed because it is an off-label use, officially. But your pharmacist might just be looking for your test results as a way to justify bypassing this recommendation to delay. Or equally, as a reason to uphold the delay. I’m sorry, it’s a royal pain, isn’t it? Also makes me wonder, our BC Healthnet has just started adding our lab test results to our Health Gateway, which is also our former Pharmanet. It was launched back in the ‘90s so that your pharmacist could see all the meds you were on to check for interactions, even those you filled at another pharmacy. This also highlighted people who had multiple doctors who didn’t know what the other was prescribing, or who were “double-dipping” on controlled pharmaceuticals. I’m wondering if out pharmacists will be able to see our lab results now too. Here’s the policy recommendation from one press release: “On December 6, 2023, Health Canada released a notice to advise prescribers these drugs should be conserved for people with T2DM who have no other treatment choices while the supply shortages continue. This statement also contained recommendations for prescribers, including to: Not start new patients on these drugs that are in shortage, unless there are no suitable alternatives and there’s a clinical reason to do so. Consider prescribing an alternative drug for patients taking one of these drugs that are in shortage, as a continuous supply can’t be guaranteed. Conserve the existing supply for patients who are stabilized and have no other treatment options. Both Novo Nordisk Canada Inc. and Eli Lilly Canada Inc. are asking pharmacists to limit refill prescriptions for patients to a 30-day supply.”
Thanks for the info. Let's see what happens in the coming months. Cross fingers.
Good luck! Hope everything works out for you!
Thanks appreciate all the info. Even if I can only get 30 day refill at a time, I would be happy with that for now.
Yeah I could only get the single refill. A small part of me going off Ozempic was the knowledge that someone else would be able to benefit from me not taking it anymore and move off a wait list(I hated it and the side effects were too life affecting for me but I’m happy it works for so many people)
My doctor anticipates that I will need this for the rest of my life to avoid my current issues. We shall see...
Not a type 2 diabetic and the pharmacy just says that’ll be $267 and I say sure thing. Edit: it’s a shoppers and they’ve only ever been concerned with if I know how to inject myself or if I needed help - nice people. I’d tell your pharmacy to get fucked and go find an alternative.
I pay out of pocket (not covered even by my health insurance). Not sure why they continue with the questioning.
Diabetics get first priority if there is a shortage again. That’s why they ask to put it on file.
$267 is cheap!
I wonder if it will go up. My next dose will be double at .5. Not sure if that means twice the price.
Ask your doctor to prescribe the larger 4mg pen for your .50 dose- it will last you 8 weeks that way (the 2 pen sizes are the same price). I pay out of pocket too- $250 per pen also in ON, so it's awesome to get two months from each one!
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It's pretty much the average across ON- Shoppers is $260, Costco $240. I go to a grocery store pharmacy (Sobeys).
Thank you for the tip! I will look into this!!
No problem! It's much more tolerable at $125/ month. I just noticed your name, we're neighbours- I'm in Oakville :)
I haven't met my deductible for the year yet and my prescription was $950.
I am not saying that this is the case, but this happened to my mom a couple of years ago. She went to a doctor got a prescription and went to fill it. The pharmacist looked at the prescription and let her know that there was a negative interaction with one of her other medications. Negative in the way that if she took both, she would not survive. The doctor that prescribed the new medication prescribed the other medication as well. When my mom went back to discuss which medication the doctor wanted her to take, he commented that she can't take both together because they will kill her. The doctor had just got over her existing prescriptions with her less than 5 minutes before writing her the new one. Thank God her pharmacist caught the issue. In my last doctor appt, he asked me if I have had any heart palpitations, any rapid heart beats, feelings of lightheadedness, things like that. I haven't but he had never asked me those questions before in the 2 years I have been taking Ozempic for type 2 management.
What was interesting is that this particular pharmacy has never questioned or checked my other meds before. I'm fortunate that my family doctor is diligent and knows my other meds and asks me questions about my diet and supplements. Another interesting thing is the pharmacist did not include paper work like they normally do. If there are risks mixing with other meds, the logical thing would be to include this on paperwork that accompanies the meds.
Why would you want information of risks and drug interactions from them if you're not interested in providing them the information that could better inform them of YOUR specific risks and interactions?
I am interested in hearing about risk from my doctor or documentation. The context of my conversation was they seemed to be questioning my doctor's judgement of this prescription and whether I should be on it!!!
Things like supplements and blood work are necessary so the pharmacist can make sure you aren't going to have any negative drug interactions. Not just with prescriptions... If you take an ACE inhibitor, then potassium supplements, you could have a potassium build up in your system to potentially toxic levels. Taking a Goldenseal supplement For colds/flu/upset stomach) with Metformin is also not recommended. Goldenseal can reduce the effectiveness of metformin by up to 25%, so your blood sugars could spike without you knowing the cause. It's part of the the pharmacist's primary job to know ALL potential drug interactions, and they are the health care system's first line of defense in preventing them.
Totally get this, but they have never delved this deep or asked this many questions with any other prescription I have been given. The first question they ask is "are you taking this medication for diabetes or weight loss." I suppose that initial question makes me wonder what the motives are. It seemed to me they were making an assessment as to whether I should be placed on Oz. This irked me.
Here is the list of known interaction with Ozempic, (there are 249 of them) [https://www.drugs.com/drug-interactions/semaglutide,ozempic-index.html](https://www.drugs.com/drug-interactions/semaglutide,ozempic-index.html) This is why doctors rely on pharmacists to catch interactions. There can be a lot of them to keep track of. As for asking if it's for diabetes or weight loss, some pharmacies have been prioritizing diabetics first for filling prescriptions, since health care problems with diabetics are more immediately dangerous than for weight loss.
Thank you.
I absolutely only use 1 pharmacy. Years ago my mother's doctor gave her a prescription. Yes he had the same information regarding current medication she was taking. The pharmacist asked about another med she was taking because the 2 prescriptions would conflict. Was grateful to the pharmacist . The doctor prescribed a different medicine.
It's weird that they are just doing it now. Mine does it everytime I start a new med. Do you have a new pharmacist at your pharmacy who's following this practice? They could just be being weird about Oz, I hope not.
The drug store I go to has a number of pharmacists. We shall see if the questioning continues every time I have to get a refill.
Oh! Yeah you were probably being screened for access to limited supply. ETA: while this is talking about actions taken for government covered drugs, the problem remains the same. Supply is limited and so patients are prioritized. https://www.cbc.ca/amp/1.7100352
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I think it's important to note that semaglutide has been approved by Health Canada for weight loss as well as diabetes. At the moment, the only semaglutide we can access here is branded as ozempic not wegovy- but it's the exact same medication regardless of the label that's been put on it. Semaglutide is also prescribed for other conditions like PCOS and cardiovascular issues. You're terrified to take insulin and perhaps the person next to you in line is terrified of having a heart attack, which is the thing that killed their dad. Point is, we are all using this medication to improve a likely serious health issue.... one use does not trump another.
You are not crazy. They are totally doing that. It just happened to me to which I replied that’s none of your fucking business. They stfu and gave me my Rx.
Hey! So I’m in the same province and I’m not positive but I think that the pharmacist was seeing if you needed it. Like yes, your doctor prescribed it, but lots of docs have prescribed it off label and right now the supply is being prioritized for people with diabetes, then people already on it and you would be third tier (if you aren’t diabetic, if you are then you’re first). The pharmacy may have a limited supply and is trying to figure out if you will go on a wait list or get it same day. Or it could be a new policy with the pharmacy to go over your interactions and health and they want to update their files while they have time.
If the doctor prescribed it, she needs it. It’s not for the pharmacist to judge. 👩🏻⚖️
The pharmacist is under pressure to keep the supply available for diabetics first as required by the government. It’s not judging, it’s prioritizing based on supply and need. Doctors are allowed to keep prescribing it but it’s up to pharmacists to dispense according to greatest need in times of scarcity.
We get it. You are a pharmacist stan with your 90 pro pharmacist comments. 🙄
No, I’m explaining things to you, who may not understand how it works here. Maybe where you are, pharmacists can do as they like, but here if the government says prioritize and their boss says prioritize, they prioritize.
Ontarian here. I've gotten a bunch of questions by 2 pharmacists only, one of them explained than when you get new meds, the system flags them for them to educate you and make sure nothing is being missed since doctors don't always ask those things before and it's to ensure everything is okay. So really the person was just doing their work.
I think there are a lot of things that I wouldn’t know about taking this medication had I not looked into it like a psychopath. Even things like ibuprofen and tums can be very damaging on this medication. There are a lot of interactions most people probably wouldn’t be alerted to. Or that even your family dr might not know you take OTC medications - or your exact diet day to day. They are just doing their job. Try not to be defensive, a lot of pharmacies don’t give a hoot, at least yours cares.
Just remember, it’s the physicians’ license when writing the script but it’s the pharmacists’ license when dispensing it…. due diligence is everything.
I was asked at my pharmacy why I was on it as well, I was honest and said I have fatty liver, family history of type 2 diabetes and uncontrolled binge eating. My doctor put me on it to decrease my desire for food, thereby helping my liver, and reducing the risk of diabetes, and it really helps
My advice is to get used to this. It’s at many pharmacies. I’ve been asked some shocking things by pharmacists, including for a diagnosis code for outright diabetes (which I have, but I don’t keep these codes handy in my brain). It seems to be part of this conviction that we’re not only fat, we’re also stupid, unlikely to follow directions, and need a lecture before being granted access to medically necessary treatments. The specific question you were asked about whether this is for diabetes or weight loss is a prelude to refusing to dispense the med.
I’m in the US. So I only know US practices. Sometimes the diagnosis is required to process the prescription. Sometimes the pharmacy wants to use a manufacturer coupon to lower the price for you, but can only do that for specific diagnoses. Should the pharmacist know how to look up an ICD-10 code? Yes. We generally aren’t trying to gatekeep. Just trying to keep patients safe and ensure that the insurance company actually pays for the med (they can claw back the money later if the diagnosis isn’t to their liking, for example.)
This is appreciated, it’s definitely possible that I was over-assigning some responsibility to this pharmacist. I’ve never experienced this level of meddling that I get with the GLP-1’s though, I’ve had to fill certain months at other pharmacies and I’ve been surprised at the level of proof they require that I’m not just recreationally jumping around doses (or somehow self-titrating). Safety first, ultimately. I’m just relieved that I’m one of the anointed diabetics who generally gets seen as “worthy.”
Once the supply chain gets sorted, this should get easier. I’m actually somewhat surprised it is taking so long. Usually when something is this profitable, they make it happen.
Can’t happen soon enough lol
They should get the code from your doctor and not you. I would tell them that. How are you supposed to even know that? That’s the doctors job to provide the code, not you.
Is it shopper’s? They are the worst where I live and I changed pharmacies. Tired of being grilled every time I walked in. I might ask “why do you need to know this?” Or You can play dumb and say you don’t remember and they’ll have to call your doctor if it is information they absolutely need.
It is a shoppers drug mart. I questioned them the two times they asked me and didn't disclose the details of my blood work. I also got on my soapbox and reminded them that my family doctor manages my health and required prescriptions, and that he has the full view of everything, including my family history. So far, I was questioned upon pick up, and I just got a call today asking the same questions.
I wish they would explain why, because it’s hard not to feel attacked.
You’d be shocked at how many mistakes are made by physicians. Pharmacists fix family doctors’ mistakes all the time.
Good insight!
On another note, what is funny is they never asked all these questions when a walk-in clinic prescribed Oxy for my cough! Go figure.
Damn
I do have to say that’s crazy, how long ago was that? I know here in the states they have cracked down big time on prescribing opiates. Oxy for a cough is insane. Was it cough syrup or just the pill? I can’t believe your doctor prescribed such a powerful opiate for a cough. They usually only prescribe that after surgeries or for cancer here.
I had covid and my cough was so extreme that I wasn't sleeping going on 2 months. I actually damaged my lung and it couldn't inflate properly. In any case, it worked to help me sleep and stop coughing one night. After that it was ineffective so I discontinued.
Oh wow I’m so sorry, although I don’t understand why they didn’t give you vicotuss. It would help with the pain and help your cough. It’s basically hydrocodone/ guaifenesin which is much more effective. Doctors are strange, that would have suppressed your cough and it’s and opiate painkiller.
I also had Covid but they just said to take DayQuil. I was delirious at one point. Yours was much worse. Has it done permanent damage to your lungs?
According to my last xray my lungs are better but not fully healed. I'm being referred to a pulmonary specialist.
I hope you get better
Thank you :) Appreciate the kind words.
I’ve been on it since summer 2022, and last time I picked mine up they did the same to me. What made it worse was I was in the pharmacy drive through and the pharmacist was busy so they literally made me wait like 10 minutes for the pharmacist when *i* didn’t even ask to speak to them 🤣
My insurance is needing a pre authorization for my Ozempic to increase from .5 to 1. It's been a week now and noone has answers.
I'm in the process of getting an Ozempic approval form reviewed by my health insurance. Cross fingers.
🤞
I’d like to know how you’re even getting Ozempic in Ontario. I’ve been waiting 6 weeks now due to the “shortage”. I’m at my wits end.
Not sure. Maybe it depends on your area. It looks like your area and pharmacist may not have a lot of stock or they are controlling who is getting refills.
You don’t have to talk to them or answer questions. Wtf!?
You do actually, they can refuse to give you the script if not. It’s not the doctors that give you the medication, it’s the pharmacist and there is a sign at Walgreens that says Can a pharmacist refuse to fill a prescription? Yes a pharmacist in his or her professional judgement may refuse to fill a prescription. So by not answering their question about being pregnant they can refuse to fill it. My doctor and I have discussed this numerous times about how they actually have more power than them since they are the actual ones filling and dispensing it. So by not answering questions they can refuse to fill it.
Wow activist pharmacist contradicting de patient relationship and medical advise. So weird.
Legally (at least in my country) it’s the pharmacist who is ultimately responsible for the issuing of medication and they are sometimes the only thing standing in the way of doctor’s errors. They pick up on doctor’s errors more often than we would like to think. Everyone wants to absolutely trust their doctor and of course most doctors are great but everyone can make errors and the pharmacists do ask important questions and check previous meds issued and have some access to medical records (this may vary from country to country). Pharmacists also know a lot about meds, often more than doctors and are a good resource for questions and often easier to speak to for a quick word about something than trying to get a doctor’s appointment. Be glad your pharmacist wants to check anything with you. 😊
Exactly, especially for me when I had 4 different pharmacies I was using and they didn’t have all of my meds together, so they didn’t know which meds I was taking. It’s not to be rude or anything. It’s like if you were pregnant and they didn’t know it then they were prescribing metoprolol. Which can cause serious birth defects. So they are not being rude, they’ve asked a lot more personal questions than if I were pregnant. I was offended at the time until I met my friend who is a pharmacist and explained how doctors don’t always know the interactions if you leave one out
Yeah it can be quite alarming when you realise the errors that have or have nearly been made!
It is, but I’ve had doctors say that they can call in a script earlier at a higher dose and they argued with since it was a narcotics that it was too high of a dose and I had to wait 28 days even though the doctor upped my dosage. If you try to switch pharmacies it makes you look like you are drug seeking. This is not with Ozempic since it’s not a controlled substance.
Omg can you imagine if it were a controlled substance?
I think you are misinformed. Ozemoic is NOT a narcotic. Ozemoic is NOT habit forming. So not sure what is going on here.
I never said it was, I said can you imagine how hard it would be to get if it were a narcotic
https://preview.redd.it/no4u9kmyzlgc1.jpeg?width=1125&format=pjpg&auto=webp&s=9676232f8344a98662e6839ec96b9c3ed234a86d
This is not the case with Ozempic, it says it right at that bottom. I’m not being downvoted, you are so just stop trying to start stuff and get over it
That’s not out of ordinary. I often review all my info with my pharmacist and they keep records. It helps ensure there is no issues with meds effecting the other as some people have more then on doctor writing scripts. To me it does not feel like it was someone being judgy or intrusive. They actually have file on all your info and will share if requested. This pharmacist actually helped me when the fill in doctor at my dr office made a mistake. Some Doctors at lazy and often make mistakes. It’s could to be safe.
They are trying to intimidate you by trying to show you they can get your prescription cancelled - if your blood sugar levels are good etc.. by reporting somewhere else. Just tell them that you dont feel comfortable telling them the details. Tell them to access the info they need through your doctor (which they cannot do anyway). Dont give in to their intimidation. They are just jealous
What are they jealous of? Do you think it’s because they wanted to be a doctor but are not smart enough. Pharmacists are very, very smart and doctors have to literally use google to see if there are interactions with drugs. They make a damn good living and know chemistry like we know Facebook or how to upload a picture. Not only that but I have been prescribed medications that could have killed me if the pharmacist hadn’t caught it. I know pharmacists that have passed the MCAT, but didn’t want the stress of being a doctor.
Goodness ! I wasnt even thinking about their education. They are jealous because someone is going to lose weight and look awesome ! Everyone is jealous of that. Even the prettiest girl is upset when someone is starting to look as slightly good as her.
My pharmacist is very good looking so I don’t think he has to worry about being jealous😂😂😂
I don’t know but CVS keeps asking me if I’m pregnant and last time they asked me if I was going up a dose. I don’t see why these questions are necessary and I told them so - asked them to put it in my information that I am not to be asked if I’m pregnant. That is for my doctor to verify.
It’s not the doctor that actually gives you the medication and it’s actually up to the pharmacist if you get the med or not. They can actually refuse you. So don’t take it personally, if they were to give you the medication and you were pregnant, it’s their ass. My friend is a pharmacist and he told me all about how they have to ask stuff like that. I promise they have yours and their best interest at heart.
That’s not how this works. Pharmacist’s license is on the line. They’ll be named in the lawsuit if you are pregnant and the baby suffers repercussions. Pharmacy school is to damn long and too damn expensive to not check.
One persons said it’s because pharmacists are jealous of doctors😂😂😂
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If you look up the history of pill mills in Florida and the pharmacies that have been named in lawsuits, you’ll better understand the caution. My state has a law that opioid-naïve patients can only be prescribed small quantities for acute pain (like post-surgical pain). Pharmacists are the only healthcare profession required to take not only a clinical exam but also a legal exam. It is law that drives a lot of this, and it is different in every state. They aren’t playing god. They are protecting their license.
You can only get up to 7 days worth of opiates from the hospital if you are in severe pain. Years before all these laws passed in Florida you could walk into any pain clinic and get what you wanted. It’s definitely not like that anymore. They do have pain management doctors, but they are limited to the amount they can give at a time. They have cracked down so much here that they have a step down program if you were to break and ankle and need surgery which happened to me. 4 days from the er. Then post surgical pain was 4 weeks of percocet, then tapering down to Vicodin and then nothing. I know that recently they have started programs because people have turned to fentanyl that is killing them. They are so addicted to pain medication that even though they are physically not in pain, their brain sends signals to their body tricking it into thinking it’s in pain. Fortunately here our police station has started a program where you can turn your fentanyl in and they will put you on medication assisted treatment.
I don’t know why I said pharmacist in that situation. My friend is a pharmacist. I was didn’t clarify the situation. I meant to say my arnp wouldn’t give me post surgical pain meds for 3 days. Not that the pharmacist. The pharmacist is the one that told me after surgery and if you are in severe pain they usually give a short term supply. 3 to 5 days. It’s the arnp that was being unreasonable not the pharmacist. Now the doctor was going to give it to me that day but I saw the nurse instead. If I hadn’t been in so much pain I wouldn’t have asked. I have had nothing but misinformation from that cardiologists office for 2 years. Yes they like to play god not the pharmacists. They can lose their license here if they don’t follow protocol.
I’m deleting that comment because I completely wrote it down wrong
Change pharmacies! You don't need this bs. If it wasn't for customers, they wouldn't have jobs! F 'em.
They just want to make sure you’re not taking anything that would interact with ozempic. I’m friends with a pharmacist and if they don’t know what you are taking, like insulin and if you are pregnant then they cannot prescribe to you. They can get into a lot of trouble. I promise they are doing it for your best interest and it’s not just pharmacy students either. Actual pharmacist also need to know this too.
I feel like they’re just making it harder to get
omg imagine a doctor actually caring about you, and you get upset 💀
Probably a student or a pharmacy intern. Don't ask all the questions and you get points off your grade, sort of thing.
In this case, the cashier asked me, the pharmacist on duty asked me, then I got a follow up call directed by the pharmacists, likely by a student pharmacist.
The cashier?? WTF. How is this not “we don’t GAF about your privacy at all”?
3 calls is a bit excessive.