⚠️ Availability Notice: The Weight Medication Assessment specialty is currently available only in Ontario and staffed by a select practice group of providers. This means that not all patients or providers will have access to it at this time.
Overview
The Weight Medication Assessment service allows eligible patients to receive GLP-1 medication prescriptions through an asynchronous consultation model. This service ensures a streamlined process for assessing patient eligibility, reviewing lab results when necessary, and prescribing the most appropriate medication based on clinical judgment.
Eligibility Criteria
Patients must meet specific eligibility criteria to be considered for a Weight Medication Assessment. Providers review patient responses to determine whether they qualify for treatment, and if a patient is ineligible, providers have the option to cancel a request.
System Eligibility Requirements
Patients with a BMI of 30 or higher
Patients with a BMI between 27 and 30 may qualify if they have at least one of the following conditions:
Type 2 diabetes
High blood pressure
High cholesterol
Sleep apnea
Patients must be at least 18 years old
Patients with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN 2) are ineligible
Patients who are currently pregnant or breastfeeding are ineligible
Additional Considerations for Providers
Providers will also assess other health factors to ensure the GLP-1 medication is appropriate. These include:
Presence of gastrointestinal conditions
History of pancreatitis, gallbladder disease, or chronic liver/kidney disease
Potential medication interactions
Behavioural and mental health factors
Dietary and lifestyle patterns
How the Consultation Process Works
This service follows an on-demand, asynchronous consultation model, which allows providers to review patient submissions and respond within 24 hours.
Steps in the consultation process:
Review the eligibility form: Providers will assess whether the patient meets the initial eligibility requirements based on the information submitted.
Conduct an asynchronous consultation: The provider has a 24-hour response window to communicate with the patient through secure messaging. Real-time chat is not required but may be used at the provider’s discretion.
Address patient questions: Before completing the consultation, providers must ensure that all patient questions are answered.
Determine prescription eligibility: If the patient qualifies, providers may prescribe GLP-1 medication in an appropriate form (oral, sublingual, or injectable) based on clinical judgment.
Schedule follow-up assessments: At minimum, a follow-up consultation is required every three months for a prescription renewal. Based on the patient’s clinical indication of and the GLP-1 medication prescribed, providers have the discretion to instruct patients to follow-up earlier than three months. Any provider within the practice group can manage these follow-up appointments and prescription renewals.
Lab Requirements
In some cases, a lab assessment may be required before prescribing GLP-1 medication. Providers must follow these steps:
If lab tests are required, issue a requisition, update the patient’s diagnosis to “Requesting weight loss medication (GLP-1), labs pending”, and complete the consult after answering any patient questions.
Communicate clear expectations to the patient, explaining that some lab results may make them ineligible to receive a GLP-1 prescription.
Review lab results promptly once you receive the email notification and determine whether the patient remains eligible for treatment.
Retroactively issue a prescription if a patient is eligible from the consultation summary and update the diagnosis to “Requesting weight loss medication (GLP-1) eligible”. If a patient is ineligible based on their lab results, retroactively update the diagnosis to “Requesting weight loss medication (GLP-1) ineligible”.
Prescription Options
Prescriptions are fulfilled by M-Line Pharmacy, which specializes in compounding sublingual Rybelsus. However, providers have the discretion to prescribe other GLP-1 formulations as clinically appropriate.
Compounded sublingual prescription templates
The sublingual form of Rybelsus provides a great patient experience, as it is easy to administer and does not require injections. It is ideal in a situation where a patient indicates they are needle-averse and prefer the sublingual option (which will be collected in the eligibility form).
Depending on the patient and their ability to handle side effects and how new they are to GLP-1 medication, there are 4 different prescription templates for sublingual Rybelsus:
New Patient: Ramp-Up Dosage
Sublingual Semaglutide 0.75 mg/mL or 1 mg/mL
The dosage gradually increases over the first three weeks before transitioning to a maintenance dose.
Drug Name | Sublingual Semaglutide | Sublingual Semaglutide |
Dosage | 0.75 mg/mL, 112 mL | 1 mg/mL, 112 mL |
Frequency | 0.25 mL/day for week 1; 0.50 mL/day for week 2; 0.75 mL/day for week 3; 1 mL/day for remaining 10 weeks | 0.25 mL/day for week 1; 0.50 mL/day for week 2; 0.75 mL/day for week 3; 1 mL/day for remaining 10 weeks |
Duration | 90 days | 90 days |
Existing Patient: Maintenance Dosage
Sublingual Semaglutide 0.75 mg/mL or 1 mg/mL
1 mL per day for 90 days
Drug Name | Sublingual Semaglutide | Sublingual Semaglutide |
Dosage | 0.75 mg/mL, 112 mL | 1 mg/mL, 112 mL |
Frequency | 1 mL/day for 90 days | 1 mL/day for 90 days |
Duration | 90 days | 90 days |
Side Effect Management
Common side effects include nausea, vomiting, diarrhea, abdominal pain, and changes in appetite. Patients experiencing adverse effects should be directed to Maple GP for timely evaluation and management.
Provider Compensation
Providers are compensated $45 per consultation, which includes:
Reviewing patient eligibility
Conducting asynchronous consultations
Issuing prescriptions
Completing Prior Authorization Forms, if required for insurance purposes
📌 Need support? For any questions or support related to the Weight Medication Assessment service, contact [email protected].