British Columbia has expanded its regulatory restrictions on diabetes medications, implementing new sales limitations on tirzepatide and dulaglutide to address supply shortages driven by their popular off-label use for weight loss. The province's Health Ministry announced the measures as part of ongoing efforts to ensure diabetic patients maintain access to essential medications.
Expanding Regulatory Framework
The new restrictions on tirzepatide and dulaglutide follow the province's 2023 regulation that limited sales of semaglutide, sold under the brand name Ozempic. This regulatory expansion demonstrates British Columbia's systematic approach to managing diabetes drug shortages that have emerged across multiple therapeutic agents in this class.
Under the new rules, B.C. pharmacists are prohibited from selling tirzepatide and dulaglutide to individuals who are not Canadian citizens or permanent residents and are not physically present at the pharmacy. The affected medications are commonly marketed under the brand names Mounjaro for tirzepatide and Trulicity for dulaglutide.
International Supply Pressures
Health Minister Josie Osborne identified the drugs' widespread use for weight loss as the primary driver of shortages affecting multiple countries, including the United States. The minister emphasized that the province is working to ensure people living with diabetes have continued access to the medications they require for managing their condition.
The off-label use of these Type 2 diabetes drugs for weight management has created unprecedented demand that has strained global supply chains. This phenomenon has prompted regulatory responses beyond British Columbia, as healthcare systems worldwide grapple with balancing patient access for approved indications against growing demand for alternative uses.
Implementation and Compliance
The College of Pharmacists of B.C. has been designated as the regulatory body responsible for ensuring pharmacy registrants comply with the new restrictions. This oversight structure mirrors the enforcement mechanism established for the earlier semaglutide regulations.
Despite the restrictions, the province has maintained provisions for non-residents and foreign citizens who possess valid Canadian prescriptions to purchase these medications, provided they make the purchase in person at a B.C. pharmacy. This accommodation balances supply preservation with accessibility for legitimate medical needs.
Broader Implications for Diabetes Care
The expansion of sales restrictions to include tirzepatide and dulaglutide reflects the growing challenge healthcare systems face in managing medication supply when drugs gain popularity for off-label uses. These regulatory measures represent a direct intervention to prioritize access for patients with the primary indication—Type 2 diabetes—over those seeking the medications for weight management purposes.
The systematic approach taken by British Columbia, beginning with semaglutide restrictions in 2023 and now extending to additional agents in the same therapeutic class, suggests a comprehensive strategy to address supply chain vulnerabilities that have emerged as these medications gained widespread recognition for their weight loss effects.
