TELUS Health Report reveals how ultra-high-cost drugs, weight management and generics are reshaping Canada's private drug plans

Published: 2026-04-28 09:00:13 ET T.TO

Published on 04/28/2026 at 09:00 am EDT

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:

"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:

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 HealthTELUS Health empowers people to live healthier lives and helps organizations create more productive, wellbeing-focused workplaces through global leadership in healthcare technology. Operating in more than 200 countries and territories, we support more than 161 million people at every point of their physical, mental, and financial wellbeing journey.

Our integrated approach connects the entire healthcare ecosystem: comprehensive workforce wellbeing programs, compassionate and personalized preventive care, and the technology infrastructure that healthcare practitioners and payors rely on daily. This creates seamless care pathways delivering regionalized and gender-responsive support, where and when people need it most.

Through our data-driven insights and proprietary research we are reshaping healthcare with earlier intervention and culturally-attuned approaches so individuals and organizations can thrive. Follow us as we advance our mission to become the world's most trusted wellbeing company: telushealth.com

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SOURCE TELUS Health