New research from TELUS Health, the 2025 Category watch: Trends in drug utilization for birth control, weight management, migraine and cholesterol, suggests that advances in treatment are driving change in the latter three categories, while Canada’s pharmacare program is behind some savings for private drug plans covering contraceptives – savings they say will accelerate as more provinces join the program.

The research is based on an analysis of TELUS’ database of more than 10 million privately insured individuals.

Birth control  

Looking at British Columbia, the report notes that private drug plans in B.C. experienced significant drops in the number of claims and claimants for contraceptives after the province made them available at no cost. Other provinces, even those that do not offer free birth control, also experienced declines.

Nationally, they say birth control accounted for 1.4 per cent of the company’s total book of business by eligible amount, as of June 2025. Four years ago, the share was 2.2 per cent. Contraceptives’ shares of claimants declined from 11 per cent in 2021 to 7.9 per cent by the end of the first half of 2025.

More than 25,000 people in that province still receive coverage for birth control from their private plans, as not all drugs are covered and not all are covered 100 per cent. “As well, while pharmacists can switch a prescription to a fully covered drug, claims data so far indicates this is not happening. Moreover, a number of pharmacies are not submitting claims to the new program at all,” they write. “Insurance carriers have been in communications with the province, seeking controls at point of sale to ensure submission to national pharmacare is in place at the pharmacy.” 

In other provinces, Manitoba became the second province to provide free birth control in 2024; federal funding began in April 2025. Prince Edward Island implemented its version for contraceptives and diabetes drugs in May 2025 and Yukon is working towards implementation.

“We can certainly expect to see further declines in contraceptive’s share of the private drug plan spend, especially as pharmacies adopt measures to submit eligible claims to federal pharmacare as first payor,” adds Vicky Lee, director of pharmacy consulting and professional services, payor solutions with TELUS Health.

They add that overall, birth control is a low-cost category for private plans. Pricing is also declining, likely due to the growing availability of generic drugs.

Weight management  

TELUS says private plan spending on weight management drugs has quadrupled since 2021 but adds that the category’s impact remains low at this point, accounting for 2.4 per cent of total eligible amount, one per cent of claimants and 0.4 per cent of claims.

The report notes, however, that fewer than half of private plans automatically cover any weight management drugs. Fewer than 20 per cent of Canadians with private drug benefit plans have coverage. This is changing as more recognize the drugs as a treatment for chronic disease and not just a lifestyle drug, but also as more companies consider coverage for the purpose of employee attraction and retention.

“Within the category, the eligible amount skyrocketed by 104.1 per cent in 2024,” they write, adding that the potential patient population for the drugs is significant as almost two thirds of Canadians are classified as either obese or overweight, according to recent data from Statistics Canada.

The report also looks at individual drugs’ impacts, by region and average eligible amounts by claimant (up 27.8 per cent over 2023).

Migraine  

This class of drugs continues to expand the market as more eligible patients shift their utilization to higher cost options available for migraine prevention. The migraine category share of total eligible amount was 1.4 per cent by the end of 2024, up from 1.1 per cent in 2021. By the end of the first six months of 2025, the category inched higher, to 1.6 per cent.

Shares of claimants and claims remained stable, while costs increased. They say this reflects the higher cost of preventative medications.

Plan sponsor’s spending increased 26.7 per cent in 2024 while the number of claimants grew just 6.4 per cent. They add that migraines and severe headaches are more prevalent in the workplace than arthritis, diabetes and depression. “Preventative drugs’ share of claimants climbed from 2.4 per cent in 2021 to 6.9 per cent in 2025,” they write. “Their share of the eligible amount grew from 26.7 per cent to 46.1 per cent.” 

Cholesterol  

High-cost drugs in this category are driving spending – a subset of pharmaceuticals aimed at helping those unable to bring down their cholesterol levels using first line, generic drugs. “Aging millennials and members of Generation X are likely expanding utilization overall,” they write.

For years the category remained virtually unchanged at 2.2 per cent of TELUS Health’s book of business. In the first six months of 2025, however, they note that the category’s budget impact relative to other categories may be growing: “Share of claimants grew significantly compared to previous years, to 13.8 per cent and its share of the total eligible amount bumped up to 2.3 per cent,” they state. “Trends within the category tell the story of expansion due to both utilization and the cost of medications.”