B.C. embraces shift to cheaper biosimilar drugs in a first for Canada

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      British Columbia is transitioning to cheaper options for certain medications.

      Yesterday (May 27), health minister Adrian Dix announced a shift from biologics to biosimilar drugs for a number of ailments.

      "B.C. is leading the country by promoting the widespread use of biosimilars, which have been proven to work just as safely and effectively as higher priced biologics,” Dix said quoted in a media release. “To date, Canada is far behind European jurisdictions. Biosimilars are a necessary step to ensure PharmaCare provides existing coverage for more people and funds new drugs well into the future."

      Bioengineered drugs (commonly referred to as biologics) are a category of medications that use living organisms—usually bacteria or yeast—to treat diseases such as diabetes and cancer. They are often very expensive. After a company’s 20-year patent on a biologic expires, competing manufacturers can sell biosimilar medications that closely resemble the original biologic, (like with brand name and generic drugs). And biosimilars typically sell for 25 to 50 percent less than their biologics counterparts.

      “Biosimilars are approved for sale just as any other drug,” states the province’s release. “In fact, Health Canada will not approve a biosimilar for sale unless it is proven to have no clinically meaningful difference to the patient compared to the original biologic drug.”

      It's noted there that biosimilars are “the single biggest expense for public drug plans,” and that, while certain biosimilars are already available in B.C., that their adoption lags far behind other jurisdictions.

      "We know that our use rates can be much higher,” Dix said. “For example, the biosimilars for infliximab (known as Inflectra and Remsima) have combined 5 to 10% use rate in Canada after four years on the market, compared to Norway (98%), United Kingdom (90%) and Scotland (85%). As a result, in 2017, Canada spent over $1.1 billion on the original biologic drug called Remicade.”

      Patients receiving biologics for diseases such as diabetes, arthritis, and Crohn's disease will have six months to transition to their biosimilar equivalents, after which point the biologics will no longer be covered by B.C.’s PharmaCare plan. (Doctors can apply for exceptions for specific patients.)

      “By increasing the use of biosimilars, B.C. will save about $96.6 million over the first three years which will be redirected to support additional drug listings and improved patient coverage,” the release states.

      The province consulted with stakeholders and they are quoted in the release expressing support for the transition to biosimilars.

      "In my work leading Canada's largest arthritis patient organization, I hear every day how patients like me are struggling to gain reimbursement for the medications they and their rheumatologist feel they need,” said Cheryl Koehn, president of Arthritis Consumer Experts. “Today's announcement is a direct answer to this problem, clinically and financially. It ensures continued reimbursement coverage for British Columbians who transition to the next generation biologic and ensures that reimbursement for other patients becomes available.”

      Canadian Arthritis Society executive director Christine Basque is quoted in the release stating her organization will monitor its members’ transitions to biosimilars and continue to consult with the province.

      "The evidence now clearly indicates that transition from original biologic to biosimilar can take place safely and without impacting patient care,” she said. “Our top priority has always been to ensure that patients have access to necessary and appropriate treatments, along with trusted, evidence-based information.”