Glucagon-like peptide-1 therapies remain a major cost driver of employer-sponsored drug plans and will further contribute to costs as they become approved for uses beyond managing obesity and diabetes, according to a new report by Alberta Blue Cross.
The report, which reviewed more than 440 new drug and supplemental submissions made to Health Canada in 2025, noted future expanded uses of GLP-1s could include metabolic dysfunction-associated steatohepatitis and obstructive sleep apnea.
There are also multiple new GLP-1 therapies under development, the report noted. These treatments are expected to be more effective, have broader uses, last longer between doses and will increasingly be available in oral form. While a semaglutide generic is expected in mid-2026, overall GLP-1 therapy plan spend is unlikely to decline in future years due to growing use and continued expansion of GLP-1 therapies.
There are emerging neurologic therapies as well, including a medication for Alzheimer’s disease that works by altering the disease process rather than just treating symptoms. However, changes to health care practices will be required to facilitate its use. Also, a new medication for progressive multiple sclerosis is under Health Canada review.
The women’s health pipeline continues to expand, with a second non-hormonal treatment for menopausal symptoms and the first targeted therapy for postpartum depression recently being approved in Canada.
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Biologic therapies are expanding to more uses, including chronic obstructive pulmonary disease, chronic spontaneous urticaria, chronic rhinosinusitis with nasal polyps and vitiligo. While these treatments improve patient outcomes, they also bring biologic-level costs to conditions with longer treatment durations and broader prevalence.
A new cream is now being marketed for the treatment of moderate-to-severe chronic hand eczema, which is the most common occupational skin disease, and a new intranasal epinephrine could be an alternative to traditional epinephrine auto-injectors, such as EpiPen, for treating anaphylaxis.
The report also highlighted several notable generic medications and biosimilars that could provide significant cost savings which are currently under review by Health Canada. One is a biosimilar version of Simponi which is indicated for multiple inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and ulcerative colitis.
Read: Innovative new drugs improve health outcomes, productivity and plan sponsors’ bottom lines