British Columbia Becomes the First Canadian Province to Mandate a Switch to Biosimilars

Officials in British Columbia announced on Monday that patients currently taking reference biologics for rheumatological diseases and diabetes will be switched to biosimilar products within 6 months.

The new policy will affect the approximately 20,400 British Columbians who have diabetes, ankylosing spondylitis, plaque psoriasis, psoriatic arthritis, and rheumatoid arthritis. Patients will have 6 months to work with their healthcare providers to transition to a biosimilar from their current reference product, and after November 25, 2019, PharmaCare, the publicly funded national drug coverage program, will no longer provide coverage for reference products other than in exceptional cases (such as when physicians deem individual patients medically unable to transition).

Patients who currently receive reference etanercept (Enbrel) will transition to Samsung Bioepis’ Brenzys (which is also approved in the United States as Eticovo) or Sandoz’s Erelzi. Those taking reference infliximab (Remicade) will be transitioned to Celltrion’s Inflectra or Samsung Bioepis’ and Merck’s Renflexis. Those who currently receive reference insulin glargine (Lantus) will be transitioned to Boehringer Ingelheim and Eli Lilly’s Basaglar.

Officials said that, as an immediate effect of the move toward lower-cost biosimilars, the province was able to make available 2 high-cost innovator drugs: the diabetes therapy empagliflozin (Jardiance) and the psoriatic arthritis drug ixekizumab (Taltz). Access to other products, such as rituximab and certolizumab, will also be expanded on the strength of the $96.6 million (approximately US $71.6 million) over the first 3 years of the program.

In the coming months, officials noted, the approximately 2700 patients receiving biologic treatment for inflammatory bowel disease will also transition their treatment to biosimilars, and more details of this switch will be made available shortly.

In a statement, Biosimilars Canada, a trade group representing biosimilar developers, applauded British Columbia on its decision. “Biosimilar medicines have an important role in supporting health care sustainability and patient care, and Biosimilars Canada congratulates the Government of British Columbia for its Canadian and North American leadership in promoting and expanding the use of biosimilar medicines,” said Michel Robidoux, chair of Biosimilars Canada and president and general manager of Sandoz Canada.

“Switching or transitioning patients from original biologic treatments to their corresponding biosimilar medicines is the responsible choice for those who manage drug budgets, and will help to ensure patient access to essential treatments for years to come,” added Jim Keon, president of Biosimilars Canada.

Biosimilar developer Merck also weighed in; in a statement, Anna Van Acker, president and managing director of Merck Canada Inc, said, “With this announcement, the government of British Columbia has reinforced the important role biosimilars can play in our healthcare system in helping broaden access not only to biologics, but also to innovative medicines overall.”