The TELUS Health 2026 Drug Trends Report shows a single rare-disease drug costs up to $600,000 annually, generic Ozempic will cost 35 per cent less, and a small two per cent of claimants drive one-third of total private drug spend.
TORONTO, April 28, 2026 /CNW/ - The TELUS Health 2026 Drug Data Trends & National Benchmarks Report, released today at the TELUS Health Annual Conference reveals a surge in private drug plan use is causing a sharp rise in high-cost specialty therapies, creating opportunity and financial pressure for plan sponsors. Among the key findings, a new generation of ultra-high-cost therapies such as Trikafta and Ultomiris are reshaping plan risk, and the imminent arrival of generic Ozempic is set to shift one of the largest drug categories.
"This year's data shows a system under productive pressure. More people in Canada are using their drug plans and they're accessing treatments that were unattainable a few years ago," said Vicky Lee, Pharmacist and Director of Pharmacy Consulting & Professional Services, TELUS Health. "The arrival of Zepbound and availability of generic Ozempic will drive the continued growth of the weight management category, alongside the increase in specialty therapies. However, the resulting cost pressures emphasize the need for plan sponsors, insurers and advisors to implement robust risk management for long-term drug plan sustainability."
The growing tension for plan sponsors to provide access to life-changing medical innovations while ensuring private drug plan sustainability is justified. 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 eligible drug spend in 2025. Trikafta (elexacaftor, tezacaftor and ivacaftor), a breakthrough therapy for cystic fibrosis, dominated this category at approximately $300,000 per year, representing 47.7 per cent of eligible spend. Ultomiris (ravulizumab), used for rare blood disorders and neuromuscular diseases, ranked second at up to $600,000 annually. The number of claimants using ultra-high-cost drugs grew by 12.2 per cent in 2025. While only used by 0.03 per cent of claimants, this category reported an average annual eligible amount per claimant reaching $190,446.32.
Key findings from the 2026 report include:
- More people in Canada are using their drug plans: 61.8 per cent of insured plan members made at least one claim in 2025, up from 58.7 per cent in 2023. The average number of claims per claimant remained steady at 12.2, while the average annual eligible amount per claimant rose to $1,079.04, up from $1,036.67 in 2024.
- Weight-management climbed six positions to rank 11th among all drug categories: The category grew 61.0 per cent in 2025 (after 104.0 per cent growth in 2024) and accounted for 2.5 per cent of total eligible drug spend. Two new developments will drive further growth in 2026:
- Zepbound (tirzepatide), capable of reducing body weight by up to 20 per cent, became available in July 2025 and is expected to rapidly gain market share.
- Generic Ozempic is expected in late 2026 at approximately 35 per cent of list price, reducing annual costs from $1,500–$6,100 to $500–$2,100.
- Skin disorders surge to second place: Skin disorders overtook inflammatory diseases to reach second place (9.9 per cent of total spend) driven by biologics Dupixent and Skyrizi becoming first-line therapies for atopic dermatitis and psoriasis. The category grew 13.6 per cent in eligible amount in 2025 and the average annual cost per claimant rose 14.2 per cent.
- Biosimilar adoption accelerates: 67.4 per cent of biologic claimants used a lower-cost biosimilar in 2025, up from 44.6 per cent in 2023, revealing a 51 per cent increase in two years. Generics reached 70.8 per cent of all claims.
- Canada's aging workforce drives disproportionate spend: Claimants aged 45–64 represent 38.5 per cent of claimants but account for 56.4 per cent of total eligible spend, indicating a structural pressure point for plan sponsors.
- National Pharmacare reshapes the landscape: Canada's Pharmacare Act for diabetes drugs took effect in October 2024, with Manitoba and PEI launching programs in 2025 and BC in March 2026. As more provinces join, private plan exposure to diabetes drugs, which is currently the number one category at 13.2 per cent of spend, is expected to decline.
- Atlantic Canada experienced the highest rate of growth: Atlantic Canada reported 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. The split between high-cost specialty and traditional drugs is highest in Atlantic Canada, resulting in the region outpacing national growth in costs.
"An evidence-based plan design is critical," adds Lee. "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."
Key provincial findings:
- Regional differences shaped by public policy:
- Thirty-day dispensing practices in Quebec drive the highest national claim frequency (17.5 claims per person), resulting in a lower cost-per-claim but the highest total annual cost per claimant at $1,355.25.
- Universal drug plans in B.C., Saskatchewan, and Manitoba keep Western Canada's average annual cost at $787.41, nearly 42 per cent lower than in Quebec.
- Quebec's specialty market expands: The province led the country in cost-per-claim growth in 2025 (4.2 per cent vs. 3.2 percent nationally), fueled by a shifting specialty drug split. However, a stable utilization rate helps keep overall regional growth aligned with national averages.
- Specialty drugs and private plan use increase in the West: Western Canada experienced the fastest growth in specialty drug share, rising 3.9 per cent in 2025 (compared to 3.7 per cent nationally) following a significant 8.4 per cent jump in 2024 (compared to 4.8 per cent nationally).
The TELUS Health Annual Conference, which brings together key stakeholders across healthcare, insurance and benefits sectors, features the 2026 Drug Trends Report as its cornerstone. This year's conference pioneers a comprehensive approach to connected healthcare, encompassing pharmacy, physician and public health sectors, while reaffirming our dedication to health benefits solutions. Analyzing data from over 15 million insured people in Canada and trends dating back to 2008, the report is a testament to TELUS Health's commitment to delivering data-informed and technology-driven solutions that adapt to changing environments, strengthening connections between healthcare practitioners, insurers and the communities they serve.
About TELUS Health
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Kaya Arai
TELUS Health
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SOURCE TELUS Health
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