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As we mentioned in our bulletin last February, 2019 will be a pivotal year for biosimilars in Canada. On May 27, British Columbia began imposing biosimilars to current users of biologic prescription drugs.
This new initiative is expected to have a significant financial impact on users, who could save anywhere from 25% to 50% on their prescription drug bill. Because biologics are generally very expensive, this change will result in substantial savings. With this measure, the BC government projects it will save nearly $100 million over the next three years, as most of its residents are covered by the public drug plan beyond a yearly deductible.
What are biosimilars?
As with brand-name drugs, other pharmaceutical companies are free to enter the market with their own version of a drug once patents on biologic drugs expire. Biosimilars are near-identical copies of biologics. However, because they are made from living organisms, it is difficult to reproduce the exact composition of biologics as is done with chemical compounds (e.g. Aspirin or other drugs). Many jurisdictions are therefore hesitant to impose a switch to biosimilars, despite supporting evidence of the safety and efficiency of these medications.
While numerous biosimilars currently exist in the market, the new rule will affect users of Enbrel, Remicade and Lantus, to treat certain medical conditions only. Patients must consult their physician to modify their prescription and will have six months to switch to the biosimilar version. Some exceptions will be allowed for the continued use of original biologics.
Potential impact on private plans
As BC’s provincial plan will no longer cover the three drugs in question after November 26, 2019, all excess amounts currently covered by Fair PharmaCare would have to be borne by private plans in the absence of harmonized control measures. Joint initiatives are therefore required for insurers and private plan sponsors in order to mitigate the impact of cost increases.
British Columbia’s decision fosters the implementation of a range of new prescription drug cost control measures. Canada lags behind other jurisdictions in terms of biosimilar availability. The introduction of new legislation forcing the switch to biosimilars when medically possible for current biologic drug users would usher a larger number of biosimilars into the Canadian market, resulting in significant cost savings across the country.
While this is a first step, other provinces should follow suit to standardize this measure throughout Canada. Potential repercussions on private plans should be analyzed based on measures adopted by the different governments. Private plan sponsors would be called upon to communicate with their members in order to standardize these new rules, as is the case in other countries.
There is nothing better than personalized support to fully understand the existing or potential impact of these changes on your drug insurance plans. Contact us!