RxBenefits: Top 10 Medications to Watch in 2026: A Guide for Labor Funds

Top 10 Medications to Watch in 2026: A Guide for Labor Funds

For labor fund administrators, keeping costs down while providing quality care can be an ongoing challenge. As the healthcare landscape rapidly evolves, new specialty drugs and high-impact therapies continue to drive plan spending and reshape treatment options.

With new treatments coming to market in 2026 and beyond, early awareness is key to strong pharmacy benefits management. Being prepared allows fund administrators to anticipate challenges, seize cost-saving opportunities, and ensure the best possible outcomes for members.

Top 10 Medications to Monitor in 2026

Specialty medications make up a disproportionate amount of total plan spend. Anti-inflammatory medications and dermatologics heavily drive this utilization, with drugs like Humira, Stelara, SKYRIZI, Dupixent, and Otezla dominating the space.

For diabetes and obesity treatments, GLP-1 receptor agonists continue to lead in this crowded and highly competitive market.

Beyond dermatologics and weight loss medications, the 2026 pipeline includes specialized treatments that target complex conditions. Monitoring these new drugs is crucial for anticipating high-cost claims.

• Icotrokinra (Johnson & Johnson): This is the first oral Interleukin-23 (IL-23) inhibitor designed to treat psoriasis and offers an alternative to injectable drugs. With potential U.S. Food and Drug Administration (FDA) approval in the third quarter of 2026, PBMs will likely be evaluating Icotrokinra for formulary placement in late 2027.

• CagriSema (Novo Nordisk): CagriSema is a weekly dual-agonist injectable for weight loss. Expectations for this drug have fallen slightly short when compared to Zepbound.

• Retatrutide (Eli Lilly): Expected to gain approval in the second half of 2026, this once-weekly triple-agonist shows promise for weight loss and diabetes. Retatrutide is expected to outperform several existing options.

• Orforglipron (Eli Lilly): This oral, once-daily medication for weight loss and diabetes is poised to compete with Wegovy.

• Pelacarsen (Novartis): Pelacarsen is an antisense therapy being developed to target high Lipoprotein(a) and lower heart disease risk.

• Ivonescimab (Summit/Akeso): This antibody treatment is aimed at immunotherapy-resistant lung cancers.

• Inlexzo (Johnson & Johnson): Inlexzo is a targeted intravesical therapy for bladder cancer.

• Zilganersen (Ionis): This antisense therapy is a new treatment for Alexander disease, a rare neurogenerative disorder.

• VOYXACT (Otsuka): VOYXACT is a monthly, self-administered antibody injection for the treatment of immunoglobulin A nephropathy (IgAN), a kidney disorder.

• Exdensur (GSK): This twice-yearly injectable is designed to control severe asthma.

Considerations for Labor Fund Administrators

• Specialty drugs, while representing less than 2% of prescriptions, often drive over half of total plan costs.

• Anti-inflammatories and dermatologics (e.g., Humira, SKYRIZI, Dupixent) remain major cost drivers, but new options like Icotrokinra may shift usage and pricing.

• Weight loss and diabetes drugs (GLP-1s) are highly competitive. New entrants in the market, such as CagriSema, Retatrutide, and Orforglipron, will likely impact plan costs and utilization.

• When evaluating the costs of GLP-1s, consider the corresponding medical benefits. Effective weight loss can prevent expensive orthopedic surgeries, improve cardiovascular health, and reduce metabolic syndrome complications.

Action Steps

As these new drugs hit the market, fund administrators should take steps to protect their plans from unchecked spending while ensuring members receive optimal care.

• Strengthen independent clinical management with prior authorization and step therapy, especially for high-cost specialty drugs and GLP-1s.

• Require holistic support programs – pair drugs like GLP-1s with nutrition and lifestyle support programs for lasting results.

• Collaborate with your PBM to update formularies and negotiate pricing for these new therapies.

Staying informed about upcoming medications will help labor funds manage spend and support member well-being in 2026 and beyond. To further protect your fund and make confident, data-driven decisions, consider scheduling time with a labor benefits expert at RxBenefits. Working with a trusted partner provides guidance through industry changes and ensures your members receive optimal care while your fund remains financially secure.

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