Insurers report rising GLP-1 costs

What happened

On 29 September 2026, GreenShield, a non-profit health care and insurance organization, published its 2026 Drug Trends Report. The report draws on nearly 39 million drug claims, the requests people make to their insurer to pay for a drug, that GreenShield processed in 2025. According to GreenShield’s release:

• Total drug costs rose 9.5 per cent in 2025.
• Semaglutide products made up 6.6 per cent of total drug costs and grew 47.7 per cent year over year. Semaglutide is the ingredient in Ozempic, Wegovy and Rybelsus.
• The number of claimants using weight-management medications rose 42 per cent compared with 2024. A claimant is a person who made a claim.
• The anticipated introduction of generic semaglutide could increase competition and help ease future spending pressures.

Benefits and Pensions Monitor reported on 1 October 2026 on the first drug trends report from another insurer, Medavie Blue Cross. Medavie said weight-management drugs made up 2.7 per cent of its total drug spending in 2025. Medavie said about 45 per cent of plans now cover them, and among those plans they made up 5 per cent of spending, third among drug categories for that group. Medavie’s national drug strategy lead said the category entered the top 10 therapeutic categories for the first time, and that Wegovy has displaced Saxenda in use almost entirely.

What it means in Canada

These are claims data from two private insurers. They describe what drug plans paid in 2025. They don’t say what any person pays, they aren’t national totals, and they don’t set a price.

Don’t compare the two insurers’ percentages directly. GreenShield’s 6.6 per cent is a share for one ingredient. Medavie’s 2.7 per cent is a share for a category of drugs. Medavie’s lead noted that carriers sort drugs into categories differently, which changes how reports compare.

GreenShield said its findings raise questions for plan sponsors, the employers and organizations that pay for a plan, about how to keep providing access while managing costs. Medavie’s lead said Medavie made weight management a standard benefit category with prior authorization around 2019 to 2020, rather than capping coverage at a dollar maximum, and that many plans in the wider market kept older structures. So plan rules differ. The release and article we read don’t announce any change to plan rules.

If you have an employer plan

1. Ask your insurer or benefits administrator whether the plan covers weight-management drugs at all. Coverage varies by plan.
2. Ask whether the drug needs prior authorization. Ask what the form requires, who submits it, and how long an approval lasts.
3. Ask whether the plan has a yearly or lifetime limit, and which products it accepts. Our coverage page shows two insurers’ published forms.
4. Ask whether the plan pays for a generic when one exists, and whether it requires one. See our generics page for which generic semaglutide products are approved and marketed. Medavie’s lead said Medavie reassesses prior authorization when a generic enters the market for a specialty drug, and the article doesn’t say how that applies to semaglutide.
5. Ask your pharmacist for the full price with the dispensing fee, so you know what you would pay if a request is refused. See our price pages.

What hasn’t changed

These are 2025 claims, and generic semaglutide wasn’t on the market in 2025. Health Canada’s Drug Product Database shows market dates of 6 May 2026 for Dr. Reddy’s semaglutide injection and 14 May 2026 for Apotex’s Apo-Semaglutide injection. The reports can’t show what generics do to plan costs. Global News reported that the report said costs could come down in 2026 because of generic GLP-1 drugs. That is an expectation, not a measured result.

We haven’t checked pharmacy prices for generic semaglutide yet, so we make no savings claim. Nothing in these reports changes what provincial drug plans pay. See coverage across Canada for what we have confirmed by province.

What happens next

Neither source we read covers 2026 claims or gives a date for a follow-up report, so we can’t say when the effect of generics will show up in insurer data. We won’t guess.

What you can do now is check your own plan. When your plan renews, ask the questions above again, because plan rules and the products available both change. Our generics page tracks which generic semaglutide products Health Canada has approved and which are marketed.