The 2026 Drug Pipeline report from TELUS Health, looking at new drugs and new uses for existing drugs that are expected to have the biggest impact on private drug plans, this year focuses on weight management drugs, a new generic coming out for one of the world’s most expensive drugs, other generics and the pipeline for biosimilar medications.

The report notes that from a relatively large pool of potential new medications, fewer than 200 typically make it to Health Canada’s regulatory review process each year. They say the agency is currently evaluating 161 drugs, up from 159 a year ago. Completely new drugs make up 65 per cent of the pipeline, compared to 58 per cent in each of the previous two years. “The remaining submissions are for new or expanded indications for drugs already on the market,” TELUS Health’s researchers write in the report, Drug Pipeline: What private plans need to know.

The report notes that private plans’ spending on weight-management drugs has more than quadrupled since 2021, gains that are even more notable given that drugs for weight management are traditionally a standard exclusion. “It’s estimated that fewer than half of plans have opted to provide automatic coverage,” they write. “Yet the inclusion of these drugs is increasingly on plan sponsor’s minds, not only because the medications are effective and can lower benefits costs associated with the comorbidities of obesity, such as type 2 diabetes and arthritis, but also because coverage is a potential tool for employee attraction and retention.”

The report also looks at Wegovy’s use in treating an advanced form of liver disease in adults with moderate to advanced liver fibrosis. “It is the first indication for Wegovy that does not include obesity or overweight as a criterion for eligibility.” Wegovy’s patent expired in January 2026.

Cost-savings from generics

They say private drug plans can look forward to cost-savings from more than 80 generic drugs that are soon to become available for 22 brand name drugs. “The first generics for GLP-1s for diabetes (Victoza and Ozempic) and weight management (Saxenda and Wegovy) dominate the new media, coming generics for oral cancer drugs with treatment costs of thousands of dollars per month, will also provide welcome cost relief,” the report states.

It adds that 56 generics for seven brand-name type 2 diabetes drugs are steadily making their way to market. It is anticipated that some will be priced at 25 per cent and 35 per cent of the brand-name drugs, although the report notes that Saxenda and Wegovy are not covered by public plans, meaning the pricing of generic semaglutide (Wegovy) and liraglutide (Saxenda) will be determined by the manufacturer.

“The potential patient population for weight-management drugs is significant: two thirds of Canadian adults are classified as obese (30 per cent) or overweight (36 per cent), according to the most recent data from Statistics Canada,” they add.

Meanwhile, more than 20 generics are expected to come available for 11 oral cancer drugs within the next two years, pending the resolution of patent litigation. Asthma and cystic fibrosis drug generics are also expected for individual drugs in those categories.

Early onset Alzheimer's

Lequembi for Alzheimer's disease, a biologic drug for a small subset of patients with young-onset Alzheimer's disease, comes with a list price of approximately $30,000 per year, with the average length of treatment in clinical trials coming in at 16 months. It’s estimated that early onset Alzheimer's disease affects between 27,000 and 31,500 Canadians.

Finally, the report looks at the pipeline for biosimilar drugs, noting that following brisk rates of regulatory approvals and market launches in 2024 and 2025 when 22 were approved, only five biosimilars are currently under regulatory review.

Several for treating extremely rare blood disorders, are expected to drop the price of Soliris, dubbed the world’s most expensive drug when it was launched in 2007, from an average annual treatment cost around $700,000 to approximately $420,000 annually.