GLP-1 drugs have redefined the term “pharmaceutical blockbuster”. Already a USD$79 billion global market, continued growth is expected and sales could reach USD$190B in a decade. But while there is great enthusiasm for these products, cost has limited uptake, especially as insurers have been reluctant to take on coverage beyond their original intended use for diabetes. Earlier this year I noted that one market was about to face serious disruption: Generic semaglutide was about to arrive in Canada. Well, the generics have arrived, but GLP-1 sales continue to set new Canadian records.