Novo Nordisk Phases Out Rybelsus for Oral Ozempic Pill as Generic Semaglutide Hits Canada

Novo Nordisk is phasing out Rybelsus (semaglutide) as it transitions to a newer oral formulation of the drug marketed as the Ozempic pill, while generic versions of semaglutide are reaching Canadian pharmacies and the company is cutting Ozempic prices for some patients without coverage.

Rybelsus is an oral glucagonlike peptide-1 (GLP-1) medication for Type 2 diabetes. The manufacturer is introducing a newer oral semaglutide formulation under the Ozempic brand name, previously referred to as the R2 formulation of Rybelsus. The Ozempic brand is now available in two formulations — the original injectable version and the newer oral tablet. The Ozempic pill is designed to improve absorption, which means it can provide a similar effect at a lower dose than Rybelsus, and it is also smaller in size, which may make it easier for some people to swallow.

Switching from Rybelsus to the Ozempic pill requires a new prescription and a dose change. Because the newer formulation is absorbed differently, it uses lower amounts of semaglutide. Patients generally won't switch to the Ozempic pill within the first 30 days of starting Rybelsus (the 3 mg starting dose), but after that — or if already taking the 7 mg or 14 mg dose — a prescriber may switch to a comparable Ozempic pill dose. Rybelsus and Ozempic pills are taken the same way; taking them with food, beverages other than water, or other medications can make them not work as well. Because both medications contain semaglutide, they tend to have similar side effects.

In Canada, generic semaglutide products are entering the market. Health Canada approved Dr. Reddy's and Apotex's generic semaglutide, and Dr. Reddy's plans to launch its version within days, becoming the first company to sell generic Ozempic in the country and making Canada the second country with generic Ozempic after India. Exclusivity on semaglutide — the key ingredient in Novo Nordisk's Ozempic and Wegovy — expired in Canada on Jan. 4. Apotex plans to have its generic semaglutide available in Canada by the end of May. Health Canada is reviewing seven other submissions and expects to make regulatory decisions in the coming weeks and months.

Novo Nordisk said it will reduce the price of brand-name Ozempic for eligible Canadians who do not have public or private coverage, aligning their medication costs with generic alternatives. The reduced price can be accessed using a Novo Nordisk Savings Card at local pharmacies across Canada, excluding Quebec, and will be applied automatically at Novo Nordisk Care Rx operated by Rexall. Apotex said its generic semaglutide will be approximately one-third the price of Novo Nordisk's brand-name Ozempic. Dr. Reddy's chief executive said the firm will sell the therapy at a "very healthy price," and a spokesperson said it will be "competitive," without disclosing further details.

GoodRx and Novo Nordisk have partnered to introduce transparent self-pay pricing for the oral version of Ozempic, giving patients with Type 2 diabetes a more direct way to access the medication. Eligible patients can purchase the drug at pharmacies nationwide with clear monthly pricing based on dosage, starting at $149. The availability of an oral formulation offers a daily pill alternative to the injectable version of Ozempic, providing greater flexibility for patients and clinicians.

Ozempic and Wegovy currently cost hundreds of dollars a month, in some cases more than $450, depending on dosage. GLP-1 drugs work by triggering insulin release, blocking sugar production in the liver, and slowing the flow of food through the digestive system.