Weight management drugs and high-cost specialty treatments are expected to have the biggest impact on private drug plans this year, according to Telus Health’s annual drug pipeline report.

It found spending on weight management drugs has more than quadrupled since 2021. In 2024, the category doubled in size following the launch of Wegovy (semaglutide) in May of that year, while the number of claimants increased by more than half.

These drugs have traditionally been a standard exclusion from private plans, with fewer than half of plans estimated to provide automatic coverage. They’re increasingly being considered by plan sponsors, not only because the medications are effective and can lower benefits costs associated with comorbidities of obesity such as type 2 diabetes and arthritis, but also because coverage is a potential tool for employee attraction and retention.

Read: Weight management drug claims up 90.6% in 2024: report

New therapies are expected to continue driving growth. Zepbound (tirzepatide) received Health Canada approval in May 2025 and entered the Canadian market in July 2025. Clinical trials show it is capable of lowering body weight by 20 per cent. Additional weight management drugs in development include combination therapies that have resulted in average weight loss of 23 per cent and next-generation drugs targeting multiple hunger-regulating hormones with trial results of up to 29 per cent.

Treatments for generalized myasthenia gravis affect a smaller patient population but come with significantly higher costs. The report estimated 12,000 to 13,000 Canadians currently live with the condition, of whom about 1,800 have refractory disease, meaning they don’t respond well to standard treatments. Annual treatment costs for biologic therapies range from roughly $220,000 to $700,000 depending on the drug and patient weight, with one additional biologic, Imaavy (nipocalimab), under Health Canada review with approval expected early in 2026.

The report also highlighted three drugs that recently exited the pipeline. Dupixent (dupilumab) received Health Canada approval for chronic obstructive pulmonary disease in October and chronic spontaneous urticaria in November, at an annual cost of $27,000.

Leqembi (lecanemab), approved by Health Canada in October, is the first disease-modifying therapy for Alzheimer’s disease. It slows the disease in its early stages and has an annual list price of nearly $30,000. Private drug plans could see claims from the subset of patients with young-onset Alzheimer’s, those diagnosed before age 65, who represent roughly 27,000 to 31,500 Canadians.

In December, Wegovy was also approved for an advanced form of liver disease called MASH, expanding its use beyond weight management. More than two million Canadian adults live with MASH, according to Liver Canada, and the annual treatment cost is the same as for weight management.

Read: Private benefits plan sponsors’ prescription drug costs up 12.9% in 2023: report

More than 80 generic drugs are expected to become available for 22 brand-name drugs, with the largest cost relief anticipated in the categories of type 2 diabetes, weight management and cancer, where treatment costs can reach several thousands of dollars per month. Generic pricing is regulated and can reach as low as 25 per cent of the brand-name price, depending on the number of competitors and whether the drug is covered by public plans.

Generics for GLP-1 drugs such as Ozempic and Wegovy may take longer to reach the market due to the complexity of the Health Canada review process and ongoing patent considerations. Novo Nordisk has also received Health Canada approval, as of late December, for lower-cost versions of Ozempic and Wegovy that are identical to the originator drugs but priced to match the coming generics.

The pipeline for biosimilars has slowed considerably, with only five currently under regulatory review after two consecutive years of double-digit approval activity. Biosimilars are generally priced 20 to 40 per cent lower than originator biologics, but patent litigation continues to delay market entry for some treatments.

The report also noted  GLP-1 drugs may eventually be prescribed for a broader range of conditions beyond type 2 diabetes and weight management, including arthritis, cardiovascular disease and kidney disease.

Read: Claims for chronic disease drugs increasing fastest among younger plan members: report