British Columbia continues to lead the way in Canada, expanding its biosimilars program and using savings to introduce new improvements in patient care.
Biosimilars are highly similar versions of bioengineered drugs, known as biologics.
As of Aug. 20, 2020, about 1,600 patients on the drug rituximab, also known as Rituxan, will have six months to transition to one of three biosimilars, namely Truxima, Riximyo or Ruxience.
Rituximab is eligible for PharmaCare coverage as a limited benefit for the treatment of conditions including severely active rheumatoid arthritis, granulomatosis polyangiitis, microscopic polyangiitis, and relapsing remitting multiple sclerosis.
Coverage decisions are informed by evidence from international jurisdictions that have more than 10 years' experience with these innovative drugs.
“We take great care here in British Columbia to examine the evidence thoroughly,” said Adrian Dix, Minister of Health. “We have seen great successes with our Biosimilars Initiative, with thousands of patients transitioning to safe and equally effective biosimilar drugs.”
Biosimilars cost anywhere from 25% to 50% less than biologics, yet Canada is significantly behind other jurisdictions at approximately 8% use rate; other nations have upwards of 50% to 95%.
“This work is allowing us to put another $30.7 million over the next three years, in addition to the $96.6 million from earlier phases of the Biosimilars Initiative back into B.C.’s health-care system. It also adds new drugs to our formulary, meaning more people get affordable access to the medications they need,” Dix said. “The savings have allowed expanded coverage of treatments for chronic obstructive pulmonary disease and attention deficit hyperactivity disorder in adults, and treatments that mitigate the risk of heart attack or stroke.”
Health Canada confirms that patients and health-care providers can have confidence that biosimilars are effective and safe for each of their authorized indications, and that no clinical differences are expected following a change from a biosimilar to its reference biologic drug. Other federal organizations also support the use of biosimilars.
Bioengineered drugs, known as biologics, are collectively the single biggest expense for public drug plans, and their costs continue to climb. For example, in 2018, B.C. spent $84.2 million on Remicade.
The initial biosimilars program announcement in May 2019 highlighted that about 20,700 British Columbians living with either ankylosing spondylitis, diabetes, plaque psoriasis, psoriatic arthritis and rheumatoid arthritis would have six months to work with their health-care team to transition their prescription from the originator biologics (Enbrel, Remicade, and Lantus) to the biosimilar equivalent by Nov. 25, 2019. In Phase 2, about 2,000 patients taking Remicade for Crohn’s disease or ulcerative colitis had six months, from September 2019 to March 2020, to switch to the biosimilar version of infliximab.
As of April 2020, many patients had met with their prescriber and switched from a biologic drug to biosimilar versions. For those PharmaCare-covered patients taking Enbrel, 85% had switched to Brenzys or Erelzi; 84% of patients switched from Remicade to Inflectra or Renflexis for non-gastrointestinal (GI) indications, and 78% for GI indications; and 71% of patients moved from Lantus to Basaglar.
Exceptions may be granted for patients whose physicians determine they are medically unable to transition to a biosimilar. Exceptional coverage requests are reviewed by PharmaCare’s Special Authority Branch on a case-by-case basis in consultation with physician-led advisory committees, as needed.
This announcement continues to work toward improving access to prescription drugs for British Columbians. A list of drugs recently added to the PharmaCare formulary can be found in the backgrounder.
In January 2019, B.C. made a $105-million investment, over three years, to reduce and/or eliminate deductibles and co-payments for lower-income British Columbians. B.C. also held a leading role in the national Generics 2.0 agreement to lower costs of the most commonly prescribed drugs and actively participates in the pan-Canadian Pharmaceutical Alliance to negotiate for lower drug costs for all Canadians. British Columbia will continue to work to make sure everyone can afford and receive the medication they need.
Patients or health-care providers with questions about transitioning to a biosimilar can access support by emailing: Biosimilars.Initiative@gov.bc.ca
Or calling 1 844 915-5005 from Monday to Friday, from 8:30 a.m. to 4:30 p.m. (Pacific time).
For more information about biosimilars: www2.gov.bc.ca/biosimilars
Four backgrounders follow.