{"id":115452,"date":"2025-09-03T10:43:09","date_gmt":"2025-09-03T10:43:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/115452\/"},"modified":"2025-09-03T10:43:09","modified_gmt":"2025-09-03T10:43:09","slug":"manulife-is-steering-wegovy-and-mounjaro-patients-to-shoppers-pharmacies","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/115452\/","title":{"rendered":"Manulife is steering Wegovy and Mounjaro patients to Shoppers pharmacies"},"content":{"rendered":"

Open this photo in gallery:<\/a><\/p>\n

Pharmacists and patients who spoke to The Globe and Mail say patients are being asked to speak with a Shoppers Drug Mart representative before Manulife will approve their claims for GLP-1 drugs.Fred Lum\/The Globe and Mail<\/p>\n

Manulife Financial Group MFC-T<\/a> is steering patients who take the popular diabetes and weight-loss drugs Wegovy and Mounjaro to Shoppers Drug Mart to fill prescriptions, just a year after cancelling a similar \u201cpreferred provider\u201d arrangement that triggered patient and political backlash. <\/p>\n

The Globe and Mail has spoken to pharmacists and patients who say Manulife has rejected claims on GLP-1 drugs until patients speak to a Shoppers Drug Mart representative who encourages them to fill their prescriptions at pharmacies owned by grocery giant Loblaw Cos. Ltd. L-T<\/a> In some cases the patients felt they had no choice but to do so if they wanted Manulife to cover the drugs, or else they faced a lengthy process to continue using a non-Shoppers pharmacy. <\/p>\n

Khalid Bhatti, director of pharmacy and diabetes education at Durham Care Clinic and Pharmacy in Oshawa, Ont., said in the last two weeks his pharmacy has seen about 10 patients with Manulife coverage who have been asked to switch to Shoppers. \u201cIt\u2019s definitely impacting patient access to care,\u201d he said.<\/p>\n

Stephen Sorial, who runs an independent pharmacy in Toronto, said he recently had a patient describe receiving a call in which they were told their GLP-1 drug would only be covered by Manulife if it was bought at a Shoppers pharmacy. \u201cWe still manage all their other prescriptions,\u201d Mr. Sorial said. \u201cIt\u2019s just that one med they have to go to Shoppers to get.\u201d <\/p>\n

Some Wegovy prescriptions redirected to pharmacies that signed exclusive deals with insurers<\/a><\/p>\n

It is not the first time Manulife and Shoppers have struck this type of arrangement. Deals between insurers and pharmacies, known as preferred provider networks, or PPNs, were thrust into the spotlight in early 2024 when the two companies announced a deal that would have required some Manulife members to get their specialty care drugs from Shoppers pharmacies, in order to receive coverage for those drugs. <\/p>\n

The companies soon announced they had cancelled the deal<\/a> after public outcry, including criticism from a federal cabinet minister. <\/p>\n

Since then, preferred provider networks have come under regulatory scrutiny and have been the subject of two public consultations by the Ontario government, which is planning legal changes<\/a> to restrict the practice.<\/p>\n

Manulife\u2019s latest policy is part of a new arrangement it has made with Shoppers to run a specialty drug care plan for these popular drugs, which are among the best-sold in Canada. More than $2.5-billion worth of Ozempic (a sister drug to Wegovy) was sold at retail pharmacies last year, according to IQVIA data, nearly triple the next best-selling drug. <\/p>\n

Manulife, Canada\u2019s largest insurer, said in a statement sent by spokesperson Emily Vear that patients on Wegovy or Mounjaro need to \u201copt in or out\u201d of the program with Shoppers Drug Mart, and insists that buying the medication from Shoppers remains \u201cvoluntary.\u201d <\/p>\n

Loblaw spokesperson Catherine Thomas wrote in a statement that the arrangement is \u201cnot a PPN,\u201d because patients are not required to fill prescriptions at Shoppers.<\/p>\n

Preferred provider networks are not always mandatory, but often direct people to use certain pharmacies or health care providers \u2013 a concept sometimes referred to as \u201cpatient steering,\u201d which has been the subject of criticism from some health care advocates.<\/p>\n

Cheaper, generic versions of Ozempic could come to Canada as early as next year<\/a><\/p>\n

The change in how Manulife started treating claims for what it calls GLP-1 drugs began this summer when it removed Wegovy from its DrugWatch program, a list of drugs that are considered high cost to an insurance plan. Although Wegovy is on the cheaper end of high-revenue blockbuster drugs, at around $5,000 a year per patient, its popularity can mean a high aggregate cost for plans.<\/p>\n

Roberta Heiberg got a prescription for Wegovy from her doctor in May. She said when she first tried to put in a claim for the medication, Manulife denied it and said it was not covering the drug.<\/p>\n

She tried again weeks later, and Manulife said it would cover the drug if her doctor completed a special authorization form, which the doctor did. But when Ms. Heiberg tried again to fill the prescription at her local pharmacist in Calgary, the claim was again denied. She said she followed up with Manulife\u2019s call centre multiple times in the weeks after.<\/p>\n

Finally, on Aug. 27 she received a call from a woman about her Manulife coverage who said the Wegovy prescription would be covered. The woman asked what pharmacy she was going to buy the medication from, and when Ms. Heiberg said it was her regular pharmacist, the woman said the prescription could be filled anywhere, but Shoppers and Real Canadian Superstore were Manulife\u2019s \u201cpreferred locations.\u201d Both stores are owned by Loblaw.<\/p>\n

The caller said there would be no price differences in buying from Shoppers, but that Shoppers had people who would \u201cdeal with Manulife and do the billing for you and answer any questions for you,\u201d said Ms. Heiberg.<\/p>\n

That same day, Ms. Heiberg received an e-mail \u2013 which she shared with The Globe \u2013 from a \u201cpatient care specialist\u201d at the \u201cManulife SDC Program\u201d (which stands for \u201cSpecialty Drug Care\u201d), from an e-mail address that ended with \u201c@shoppersdrugmart.ca.\u201d <\/p>\n

Ms. Heiberg said her claims for Wegovy have still not gone through with her independent pharmacist, even after the call.<\/p>\n

\u201cI haven\u2019t had an experience like this with any other medications,\u201d Ms. Heiberg said. \u201cJust this one has been a bit of a nightmare.\u201d<\/p>\n

Manulife said patients should receive a call within 48 hours of receiving prior authorization for the drugs and that following the call they are free to go to a pharmacy of their choice.<\/p>\n

\u201cThese medications are not part of an exclusive pharmacy partnership, but rather a voluntary one,\u201d the insurer said in a statement. <\/p>\n

Manulife would not answer questions about any financial terms of its deal with Shoppers, or what benefit patients might receive from the arrangement.<\/p>\n

Loblaw\u2019s Ms. Thomas said the retailer offers a patient support program for people taking some GLP-1 medications. The program includes patient resources such as care co-ordinators who can answer questions and self-injection guides, she said.<\/p>\n

\u201cThey can fill their prescription at any pharmacy they choose, and this is not exclusive to any one insurer,\u201d Ms. Thomas wrote in a statement.<\/p>\n

Some other health insurers have also moved to reimburse Wegovy and similar drugs only if they are bought at in-network pharmacies. GreenShield Canada told The Globe in August it had done so because the popularity of Ozempic and Wegovy was expensive for plans. GreenShield also said it would re-evaluate that decision when cheaper generics come on the market next year<\/a>.<\/p>\n

Ian Patton, director of advocacy and public engagement at Obesity Canada, said preferred provider networks can make it unnecessarily difficult for patients to access the medication they need.<\/p>\n

\u201cIt\u2019s just hurdles and a lack of clarity for patients,\u201d he said.<\/p>\n","protected":false},"excerpt":{"rendered":"Open this photo in gallery: Pharmacists and patients who spoke to The Globe and Mail say patients are…\n","protected":false},"author":2,"featured_media":115453,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[64,63,137,490,41183],"class_list":{"0":"post-115452","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-au","9":"tag-australia","10":"tag-health","11":"tag-medication","12":"tag-ne-i"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/115452","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=115452"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/115452\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/115453"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=115452"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=115452"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=115452"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}