A new generation of ultra-high-cost therapies is reshaping benefits plan risk, while the arrival of generic glucagon-like peptide-1 receptor agonist medications is set to shift one of the largest drug categories, according to Telus Health’s annual drug report.
The report found weight-management climbed six positions to rank No. 11 among all drug categories. The category grew by 61 per cent in 2025 (after growing 104 per cent in 2024) and accounted for 2.5 per cent of total eligible drug spend.
Two new developments will drive further growth in 2026, the report noted. Zepbound, capable of reducing body weight by up to 20 per cent, becamd available last July and is expected to rapidly gain market share. In addition, a generic Ozempic is expected to arrive in late 2026 at roughly 35 per cent of list price.
Read: Weight management drug claims up 90.6% in 2024: report
Last year, specialty drugs accounted for 33.9 per cent of total eligible drug spend, despite only 2.1 per cent of claimants using them. The continued rise of ultra-high-cost drugs represented 5.2 per cent of total drug spend in 2025 and the number of claimants grew by 12.2 per cent. A breakthrough therapy for cystic fibrosis dominated the category at nearly $300,000 per year, representing 47.7 per cent of eligible spend.
Skin disorders overtook inflammatory diseases at 9.9 per cent of total spend. The category grew 13.6 per cent in eligible amount in 2025 and the average annual cost per claimant rose 14.2 per cent. Additionally, 67.4 per cent of biologic claimants used a lower-cost biosimilar in 2025, up from 44.6 per cent in 2023. Generics reached 70.8 per cent of all claims.
Nearly two-thirds (61.8 per cent) of plan members made at least one claim in 2025, up from 58.7 per cent in 2023, and the average annual eligible amount per claimant rose to $1,079.04, from $1,036.67 in 2024. Notably, members aged 45 to 64 represented 38.5 per cent of all claimants but accounted for 56.4 per cent of total eligible spend, indicating a structural pressure point for plan sponsors.
Canada’s Pharmacare Act for diabetes drugs took effect in October 2024, with Manitoba and Prince Edward Island launching programs in 2025 and British Columbia in March 2026. As more provinces join, private plan exposure to diabetes drugs, which is currently the No. 1 category at 13.2 per cent of spend, is expected to decline, according to the report.
It also noted Atlantic Canada experienced the highest rate of growth with an average annual eligible amount per claimant at 5.5 per cent, compared to 4.1 per cent nationally and a low of 3.5 per cent in Western Canada.
“An evidence-based plan design is critical,” said Vicky Lee, pharmacist and director of pharmacy consulting and professional services at Telus Health, in a press release. “The convergence of ultra-high-cost therapies, a maturing weight management market and the availability of generics means a thoughtful approach that balances the complex intersection of costs, medical innovations and regional policies is required to continue supporting the evolving healthcare needs of people in Canada.”
Read: Coverage for high-cost, specialty drugs missing from rollout of feds’ pharmacare plan: experts