Just say no: Physician regulators warn against co-signing Ozempic prescriptions

Dear fellow doctor: Will you please co-sign this prescription for semaglutide? Canadian physicians who get requests from another physician, a pharmacist or pharmacy to co-sign, rewrite or countersign a prescription for semaglutide—sold under the brand name Ozempic—should respond with a two-letter word: No. That was the message delivered recently by regulators in Manitoba and Nova Scotia, in the wake of the drug’s increasing popularity as well as media reports of Canadian healthcare providers prescribing large quantities of Ozempic to patients in the United States. Doctors who sign off on prescriptions for patients with no established physician-patient relationship would be considered in breach of several standards of practice, the College of Physicians and Surgeons and Manitoba stated on its website. The college cited, in particular, rules around direct patient contact when prescribing. Without patient contact, prescribing or counter-signing a prescription does not meet the acceptable standard of care. Read: Despite social media buzz, Ozempic is not a quick fix weight loss solution: doctors Primary communication that takes place by phone or through an electronic medical questionnaire does not constitute direct patient contact, the college noted. Doctors should also ensure they’re complying with the rules when prescribing Ozempic through virtual care. “CPSM considers the patient’s location determinative of where the practice of medicine occurs,” wrote the college. “CPSM registration does not extend to the provision of medical care in other Canadian provinces or to patients located in other countries.” In addition to cautioning doctors against co-signing Ozempic prescriptions, the college posted a list of frequently asked questions about the drug and prescribing for U.S. patients. Out east, the College of Physicians and Surgeons of Nova Scotia cautioned its registrants about prescribing or signing off on prescriptions for patients they haven’t seen or assessed in person. The college also stated on its website that it has launched a “full investigation” into Dr. David Davison, a Nova Scotia-licensed physician who practises family medicine in Odessa, Tx. Read: U.S. judge throws out lawsuit to stop states from importing drugs from Canada Dr. Davison, who has a full non-resident Nova Scotia licence, was suspended as an interim measure on April 7. While the college has not provided details about the suspension or indicated on Dr. Davison’s physician profile that he is under investigation, recent media coverage reported that B.C.’s health ministry had singled him out for writing thousands of Ozempic prescriptions. An analysis of Ozempic sales in B.C. for the first two months of 2023 found that 15% of total sales were for U.S. residents and that close to 90% were sold by two B.C. pharmacies. Of the 17,000 Ozempic prescriptions filled by these two pharmacies, 95% were written by Nova Scotia prescribers. This finding by B.C.’s health ministry prompted the province’s physician regulator to call the Nova Scotia college. “By law, the college must issue licences to qualified non-resident physicians,” the CPSNS wrote on its website. “To our knowledge, Dr. Davison has not practised in Nova Scotia for many years. Based on volume alone, this prescribing is not in keeping with the standards of the profession in any jurisdiction in Canada. On its face, the prescribing appears incompetent. The College has launched a full investigation of this serious matter.” Read: Doctor behind cross border rush for Ozempic in B.C. is suspended in Nova Scotia

Just say no: Physician regulators warn against co-signing Ozempic prescriptions

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