Public Drug Plan Spending Rose $3.4B Over 5 Years Driven by High-Cost Drugs
Summary
The PMPRB released its CompassRx 10th edition report showing Canadian public drug plan prescription spending grew 7.4% in 2022/23 to $14.1 billion from $13.2 billion in 2021/22. Over five years (2017/18 to 2022/23), total spending rose by $3.4 billion with a compound annual growth rate of 5.9%. Drugs costing over $10,000 annually were used by less than 3% of beneficiaries yet accounted for over one-third of total drug costs.
What changed
The PMPRB published its annual CompassRx report tracking public drug plan expenditures for fiscal year 2022/23. The report shows prescription drug spending grew 7.4% year-over-year, with increased use of higher-cost medications being the primary driver. Drugs exceeding $25,000 annually were used by less than 1% of beneficiaries yet represented 20% of total costs.
Affected parties including provincial/territorial drug plan administrators, policymakers, and pharmaceutical stakeholders should monitor these spending trends as they will inform policy discussions and cost pressure responses. The findings may influence drug pricing negotiations and reimbursement decisions at the provincial/territorial level.
What to do next
- Monitor PMPRB CompassRx publications for policy updates
- Review provincial/territorial drug plan cost trends
Archived snapshot
Apr 16, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
Canadian public drug plan spending grew by $3.4 billion over 5 years, driven by use of higher-cost drugs
From: Patented Medicine Prices Review Board Canada
News release
October 21, 2025 — Ottawa, ON — Patented Medicine Prices Review Board
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
Contacts
PMPRB Media Relations
PMPRB.MediaCentre-CentreMedias.CEPMB@pmprb-cepmb.gc.ca
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Search for related information by keyword: Health and Safety | Patented Medicine Prices Review Board Canada | Canada | Drug labelling, pricing and health claim compliance | media | news releases
2025-10-21 Date modified:
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