Canadian public drug plan spending grew by $3.4 billion over 5 years, driven by use of higher-cost drugs

OTTAWA, ON, Oct. 21, 2025 /CNW/ - The latest edition of the Patented Medicine Prices Review Board (PMPRB) CompassRx report shows that prescription drug expenditure for public drug plans grew by 7.4% in 2022/23 to reach $14.1 billion, compared to $13.2 billion in 2021/22. Drugs costing over $10,000 annually accounted for over one third of total drug costs for the public drug plans and were only used by 3% of beneficiaries. The 10 highest-cost drugs were rare disease treatments that each had annual treatment costs exceeding $300,000.

The PMPRB reports on pharmaceutical trends through publications such as CompassRx. The findings from this report will inform policy discussions at the provincial/territorial level, and aid decision makers in anticipating and responding to evolving cost pressures that have an impact on public drug plans. The study includes all provincial public drug plans (with the exception of Quebec), as well as Yukon. These plans account for approximately one third of the total annual spending on prescription drugs in Canada.

CompassRx provides insight into the factors driving prescription drug expenditures in select Canadian public drug plans. This edition focuses on the 2022/23 fiscal year, where increased use of higher-cost drugs continued to be the main factor driving growth.

Quick Facts

• Between 2017/18 and 2022/23, the total prescription drug expenditure for Canada's public drug plans rose by $3.4 billion, for a compound annual growth rate of 5.9%.
• Drug costs, which represent 83% of prescription drug expenditures, grew by 7.9% from 2021/22 to 2022/23. The growth was primarily driven by a sustained increase in the use of higher-cost drugs, coupled with a post-pandemic rebound in active beneficiaries.
• By 2022/23, medicines costing over $10,000 and $25,000 annually were used by less than 3% and 1% of beneficiaries yet accounted for over 37% and 20% of drug costs, respectively. Of 6.6 million active beneficiaries, the 7.6% with annual drug costs exceeding $5,000 accounted for 62.3% of total public plan drug costs.
• The top contributor to the increase in drug costs in 2022/23 was elexacaftor/tezacaftor/ivacaftor (Trikafta), a fixed-dose combination medication to treat cystic fibrosis. It ranked first after just two years on the market, driven by its high treatment cost and rapidly increasing usage. Three antidiabetics--semaglutide (Ozempic), empagliflozin (Jardiance), and dapagliflozin (Forxiga)--also collectively contributed to the growth in drug costs.
• Through the National Prescription Drug Utilization Information System (NPDUIS) research initiative, the PMPRB provides stakeholders with price, cost, and utilization information to help them make timely and informed drug pricing, purchasing, and reimbursement decisions.

Associated Links

CompassRx, 10th edition: Annual Public Drug Plan Expenditure Report, 2022/23

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SOURCE Patented Medicine Prices Review Board

Contacts: PMPRB Media Relations, [email protected]