The Régie de l’assurance maladie du Québec (RAMQ) does not reimburse drugs intended for weight loss under any circumstances, even if they are authorized by Health Canada. Doctors deplore the fact that these expensive treatments are not covered for patients who need them, in particular to access an operation or a transplant.
“In some cases, drugs could help, but currently, we are taken because Health Canada authorizes them, but the public plan does not reimburse them,” says Dr. Rémi Rabasa-Lhoret, endocrinologist and director of the Professional Council. of Diabetes Quebec.
Dr. Rabasa-Lhoret recently encountered a patient with type 1 diabetes requiring a pancreas transplant. “He is constantly in hypoglycemic comas and is hospitalized about fifty times a year despite specialized follow-up,” says the endocrinologist.
To be eligible for a pancreas transplant, his patient needs to lose five pounds, but fails. Dr. Rabasa-Lhoret therefore considered the drug Ozempic, initially intended for people with type 2 diabetes, but which has proven effective for weight loss. The doctor made a request to the RAMQ to cover the cost of this medication, which amounts to approximately $200 per month.
Although the drug is approved in Canada for the treatment of adults with obesity, the public plan denied its request. “The RAMQ absolutely must evolve. We’re putting this patient through hell and we have a solution, ”drops the specialist.
Drugs that specifically treat obesity are automatically excluded from RAMQ coverage. According to the Department of Health and Human Services, “a lot of uncertainty still remains” with respect to these drugs, including “as to the extent of the benefits and their maintenance over time”, told La Press the director of communications, Robert Maranda.
Quebec is also concerned about the risks of abuse related to the misuse of drugs primarily intended for the treatment of diabetes, but used to lose weight1. “The inappropriate use of weight loss medications is currently a major concern in both North America and Europe to the extent that supply issues are being raised for patients with diabetes,” says Mr. Maranda.
Specialists are aware of these risks.
Currently, only Australia, England, Wales and Northern Ireland reimburse these drugs for weight loss in specific circumstances, while France and the United States are looking into the question.
According to Dr. Marie-Philippe Morin, the RAMQ should allow exceptions.
A recent report by the National Institute of Excellence in Health and Social Services (INESSS) published in October goes in the same direction. “Clinicians consulted identify a need for people who need to lose weight to qualify for bariatric surgery or other surgery that could significantly improve their health and well-being,” it reads. in the report.
These drugs, however, should be used in conjunction with lifestyle modification, dietary changes, physical activity and behavioral interventions, experts note. The patient should also be followed by a multidisciplinary team, including nutritionists and kinesiologists.