From the lasting economic ripple effects of the pandemic, to the impact of new global trade tensions, uncertainty across the Canadian healthcare landscape is showing up everywhere. To help remedy such volatility, Canada’s private-sector drug plans are stepping in to protect and increase Canadians’ access to pharmaceutical care.
In fact, plan providers are more committed than ever to improve that access in order to ensure the appropriate use of medications for optimal health outcomes.
Our 2025 Drug Trend Report sheds light on the past and future of drug utilization, costs, and emerging therapies. Here are five takeaways that offer a snapshot of the forces shaping drug plan sustainability and the future of connected care in Canada.
1. Smarter plan design is supporting drug equitability
Across 2024, private drug plan spending continued its steady climb. On average, each person who made a claim had CAD$1,038 in eligible drug costs, a 3.3 per cent increase over the previous year. (Ten years ago, in 2015, the average annual eligible amount was just $668.)
This rise in private drug plan spending is the result of three things:
- More claims made per person
- Higher costs per prescription
- A growing use of higher-priced medications, including specialty drugs.
Managing this growth isn’t something the private system can do alone. As public pharmacare initiatives expand to cover lower-cost, first-line therapies, private plans are becoming increasingly more responsible for complex and costly treatments, and the two systems must work in tandem to ensure Canadians have equitable access to the medications they need, when they need them.
2. Generic drugs are a proven lever when it comes to accessibility
Generic versions of brand-name drugs captured 68.8 per cent of all claims submitted to private drug plans in 2024, up from 67.5 per cent in 2023.
While this number is moving in the right direction, there are still some lingering inefficiencies that exist when it comes to Canadians accessing more cost-effective drug equivalents. For example:
- 24 per cent of claims made in 2024 were singlesource brand-name drugs, meaning no generic versions were available.
- Only 7.3 per cent were multi-source brand-name drugs for which generics were available.
If we’re serious about sustainable, connected care, generic drug equivalents should be a baseline expectation. To achieve this, however, it requires greater coordination across public and private plans, as well as clearer guidance at the point of care and smarter engagement with patients.
3. Weight management is surging as a key drug category
Last year, weight management became the fastest-growing therapeutic category in Canada’s private drug plans, climbing from 29th to 17th place in a single year.
What’s behind this growth? The launch of a long-anticipated drug called Wegovy (semaglutide), which is capable of reducing body weight by 10-15 per cent. Additionally, there is a growing recognition that obesity is not a lifestyle issue. Rather, it is a chronic, complex condition requiring long-term management.
This surge signals a redefinition of care priorities and raises important questions about equity, access, and system readiness. Most private drug plans, for instance, don’t yet cover these therapies. However, the weight management category is slowly making its way into the default drug plan. For this to succeed, we need alignment across providers, payors, and policymakers to ensure patients can access evidence-based treatment without delay, stigma, or disruption.
4. Aging Canadians are reshaping the drug demand curve
Canadians aged 45 to 64 made up just over a third of private drug plan claimants in 2024. What’s more, this age group drove more than half of all claims and total drug spending. This is due to the fact that this generation is entering its peak years of chronic disease management, and they’re often juggling multiple conditions that require ongoing, coordinated pharmaceutical care.
Unfortunately, fragmented care systems can’t keep pace with the complexity of aging populations. Drug coverage only scratches the surface; they also need an integrated model of care that aligns public and private drug plans with clinical care pathways. This is the only way to support proactive, preventative, and personalized treatment, not only for this age demographic, but for all Canadians.
5. Specialty drugs are stretching budgets and the system
Specialty drugs, which are used by just 1.9 per cent of claimants, accounted for 32.8 per cent of total private drug plan costs in 2024. These are often life-changing therapies for people managing complex, chronic, or rare conditions.
Unfortunately, rising spend on speciality drugs signals mounting pressure on plan sustainability and affordability. Managing this requires smarter utilization controls like prior authorizations, biosimilar switching, and coordinated care to ensure the right patients are getting the right therapies, at the right time.
As more high-cost drugs enter the market, the need for integration between clinical care and benefit design will only intensify. The question is whether our public and private systems can evolve fast enough, and collaborate closely enough, to keep up.
Looking ahead to 2026 and beyond
The trends in this year’s report reinforce the urgent need for a more connected, collaborative approach to healthcare in Canada. As drug costs rise and therapeutic categories evolve, we require a system that balances innovation with sustainability, and access with appropriateness.
To read the full 2025 Drug Trends Report, visit here.