The 2026 edition of our Drug Pipeline report takes a closer look at new drugs, and new uses for existing drugs, that are of most interest to private payors. While the list of new drugs is short this year, their impact on private plans—including workforce productivity and work absences—may be significant.
Read on for five key takeaways, or get the full 2026 Drug Pipeline report here.
CagriSema for weight management is coming to Canada, joining Wegovy and Zepbound.
Private drug plans’ spending on weight-management drugs has more than quadrupled since 2021. The annual treatment cost of Wegovy, based on the public list price, is approximately $5,000. The annual cost for Zepbound is between $5,000 and $10,000, depending on the dose. The pricing of CagriSema has not yet been announced.
The first generic options for Wegovy are expected this year and may offset the growing budget impact of the weight-management category. Pricing of the generics is not known and will be determined by the manufacturer.
Health Canada’s timing to approve generics for Wegovy is also unknown due to the unique nature of drugs, which are self-injected. They are not chemical drugs but nor are they biologics, which means they do not fit into existing approval processes for generics and biosimilars.
While rare diseases disproportionately affect children, generalized myasthenia gravis (gMG) is a neuromuscular autoimmune disorder most often diagnosed in middle-age and older adults.
A small subset of patients with gMG—about 1,800 Canadians—do not respond well to standard treatments to manage symptoms. For these patients, four biologic medications have become available in recent years. One more, Imaavy, is expected soon. The annual treatment cost is between $220,000 and $700,000.
The first biosimilar options for one of those biologics, Soliris, may arrive this year as well—if outstanding patent litigation is finally resolved. Assuming a discount of 40 per cent off the list price of Soliris, these biosimilar biologics would have an annual treatment cost of approximately $420,000.
The pipeline for generics is robust, with more than 80 expected to become available for 22 brand-name drugs. Anticipation is especially high for the generic options for Ozempic and Wegovy, which are driving growth in their respective categories of type 2 diabetes and weight management.
Private payors can also look forward to more than 20 generics for 11 oral cancer drugs that currently have treatment costs averaging several thousand dollars per month. In some cases, the generics will be priced at 25 per cent or 50 per cent of the brand-name drug, as dictated by the pan-Canadian Pharmaceutical Alliance’s Tiered Pricing framework for generic drugs.
The first generic for a certain class of cystic fibrosis drug is also worth mentioning. The generic will initially be priced at 75 per cent or 85 per cent of the brand-name (which has an annual treatment cost of $250,000 to $300,000), possibly dropping to 55 per cent after three months.
In contrast to generics, the pipeline for biosimilar shrank significantly in 2026 following brisk rates of regulatory approvals and market launches in 2024 and 2025. Currently, only five biosimilars for three originator biologics are under regulatory review and will be of interest to private payors.
The 2026 Drug Pipeline report concludes with a brief look ahead. The key takeaway: more uses for the breakthrough drugs known as GLP-1s, which are currently blazing trails in the treatment of type 2 diabetes (Ozempic and Mounjaro) and weight management (Wegovy and Zepbound).
As researchers better understand and quantify the anti-inflammatory and metabolic properties of GLP-1s, private plans may see claims for conditions other than type 2 diabetes and obesity, including arthritis, sleep apnea, cardiovascular disease, kidney disease and liver disease.