Sydnie McCrea | Member Services Administrator
Obesity is a delicate topic, with many opinions about the severity of its health impacts, and many more opinions in the form of cultural stigma that goes along with being overweight. Nevertheless, what is normal weight for one body may be a health risk for another, and the number of people who struggle with weight as a health issue has been increasing in recent years.
The Government of Canada has even commented on the matter, saying, “the number of Canadians who are overweight or obese has increased dramatically over the past 25 years. Being overweight or obese increases your risk of developing a wide range of serious diseases and conditions, including high blood pressure, coronary heart disease, Type 2 diabetes, stroke, osteoarthritis, and certain types of cancer, including breast, colon, and endometrial cancer.”
Since weight management is such an important part of health for Canadians, you may be wondering: what kind of weight management drugs does ARTA cover? How do I know which one is right for me?
Weight Management at ARTA
There are many, many weight management drugs on the market, but not all are equally effective. To ensure we are supporting members with legitimate, science-backed drugs, ARTA follows Health Canada guidelines to decide which varieties are covered. There is also the matter of whether the user intends to take the drugs for health reasons, rather than cosmetic reasons. That’s why ARTA requires something called a special authorization before approving coverage; it shows that your doctor agrees you are taking the drugs for its health effects. By using special authorizations, ARTA can help manage costs and sustain coverage in the long term by ensuring these drugs are being covered by those who need it most.
You may have heard of popular drugs like Ozempic and Mounjaro being used for weight loss effects. However, these are diabetes treatments and are not approved by Health Canada to be used as weight management drugs, even if that is one of their side effects. ARTA cannot provide coverage for these drugs unless they are being used for diabetes treatment. There are, however, similar drugs that are approved for weight management in Canada.
Beginning Your Weight Loss Journey
Just like any treatment, you should be consulting with your family physician to determine what prescription would suit you and your body best. It is important to review your current health conditions, family history, and current medications before you make a choice. While there are many benefits to weight management medications, there are also many side effects.
If you are a prescribed a GLP-1 (Glucagon-like peptide 1), ARTA may cover a portion of the cost according to your chosen benefit plan. In 2024 alone, ARTA Benefits paid over $800,000 in these medications, including (but not limited to) Semaglutides and Tirzeptides, often with ARTA being the secondary payor after provincial coverage.
Semaglutides are one of the most popularly claimed GLP-1 drugs with ARTA. This includes popular drugs like Wegovy. They can be taken through injections once per week under the skin. Patients commonly self-inject using a prefilled syringe.
The second form of medication, called Tirzeptides, is a mix of two gut hormones: GLP-1 and GIP (Glucose-dependent insulinotropic polypeptides). Having the dual-action medications as a treatment may increase insulin production and reduce fat storage, promoting significant weight loss over time. Tirzeptides are similar to semaglutides, in that a person may self-inject under the skin with a pre-filled syringe.
Making the Right Choice for You
Why use a Semaglutide when Tirzeptides are more effective? Different bodies react in different ways, meaning that you might experience side effects from one, but not the other. Semaglutides also have a longer track record of success and are seen by some physicians as the safer choice, though both have received approval in Canada. There is also the issue of cost. At the time of writing, Tirzeptides are more expensive and might not be worth the added cost, depending on your goals.
As you age, and your body changes, understanding weight management becomes ever-more important. ARTA will always continue to monitor changes in the market and advise our plan members regarding the latest best practices.
Sydnie is one of ARTA’s Member Services Administrators. With over ten years of customer service under her belt, she is an expert in helping people unravel the intricacies of their health benefit plan.