Your Benefits Plan and the Drug Landscape: What's Changing in 2026

The drug landscape is shifting faster than most employers realize. New medications are making headlines, costs are climbing, and employees are coming to HR with questions that weren't on anyone's radar a few years ago.

Here are three things worth knowing right now.

• GLP-1 drugs are everywhere, and your employees are asking about them

• Drug costs are rising, and some of the increases are significant

• Generics are coming, and that’s genuinely good news

You don't need to be a drug plan expert to stay ahead of this. You just need to know what's changing. We’re by your side actively monitoring your plan and ensuring that we’re seizing opportunities for savings.

For ease, we've drafted an employee-facing FAQ about GLP-1 medications that can help avoid frustration and unintended out-of-pocket costs.

GLP-1 drugs are everywhere — and your employees are asking about them

You've probably heard of Ozempic. Maybe Wegovy or Mounjaro too. These drugs belong to a class called GLP-1s, and they're making news for their effectiveness in treating Type 2 diabetes and delivering weight loss.

Ozempic is covered by most benefits plans — but only for Type 2 diabetes. It is not approved by Health Canada for weight management, and it won't be covered for that purpose under most plans.

Wegovy is approved for weight management, but most Canadian benefits plans do not cover it. Before an employee has their doctor fill out a prior authorization form, they should check their coverage first. Some doctors charge for completing these forms — and if the drug isn't covered, the employee can incur an out-of-pocket cost and come away without coverage.

Zepbound is a new weight-management drug that entered the Canadian market in 2025, showing even stronger weight-loss results than Wegovy. Another similar drug called CagriSema is expected to receive Health Canada approval before the end of 2026. More options mean more employee questions, and more confusion about what's covered and what isn't.

What this means for you: Consider getting ahead of the questions before they land in your inbox. A simple one-page FAQ for employees — explaining what's covered and how to check before they act — can save a lot of time and frustration on both sides.

Drug costs are rising — and some of the increases are significant

Drug plan costs have been climbing steadily, and a few trends are worth keeping on your radar:

Weight management drugs alone have seen spending more than quadruple since 2021. For plans that cover these medications, the budget impact is real — and it's expected to grow as newer, more effective options enter the market.

A wave of new specialty drugs is entering the pipeline for conditions like Alzheimer's disease, COPD, and rare diseases. Some of these carry annual treatment costs in the tens or even hundreds of thousands of dollars. For example, treatments for a rare muscle disorder called generalized myasthenia gravis can cost anywhere from $220,000 to $700,000 per year. Most employers have never heard of this condition — until a claim comes through.

While most employers will never see a claim like that, it's a good reminder that plan sustainability isn't just a renewal conversation — it's an ongoing discussion.

For Alberta employers, there's an additional layer to consider. Bill 11 is shifting more drug costs from the provincial government to private plans, with changes rolling out through 2026 and 2027. If you haven't read our full breakdown yet, you can find it here.

What this means for you: Now is a good time to understand where your plan's biggest cost exposures are — especially around specialty drugs and annual drug maximums. Making sure you review your ongoing claims experience is a good step in understanding the cost drivers behind your plan.

Generics are coming — and that's genuinely good news

More than 80 generic versions of brand-name drugs are working their way through the Health Canada approval process right now. That includes generics for some of the most commonly claimed medications — including Ozempic and Wegovy.

Generic drugs are typically priced significantly lower than their brand-name counterparts. Once multiple generics are available for a drug, the price can drop to as low as 25 to 35 per cent of the original brand-name cost. For plans that cover diabetes medications, this could mean meaningful savings in the years ahead.

The timing is uncertain — the review process for GLP-1 generics is more complex than usual because of how these drugs are made. But Health Canada approvals are expected, and once they come through, manufacturers are ready to move quickly.

What this means for you: When generics do arrive, there may be an opportunity to adjust your plan design and capture real savings.

The bottom line

The drug landscape is more complex than it was even two years ago. New medications, rising costs, and changing coverage rules can feel like a lot to keep track of — especially when benefits is just one of many things on your plate.

That's where we come in. Staying on top of this landscape is part of what we do, so you don't have to do it alone.

Have questions about how any of this affects your specific plan? Even a 20-minute conversation can give you a lot of clarity. Please reach out to your consultant any time to discuss.