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Province of British Columbia
NEWS RELEASE
For Immediate Release
2020HLTH0257-001569
Aug. 21, 2020
Ministry of Health
B.C. expands biosimilars program

VICTORIA – 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. 

Learn More:

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.

 
Contact:
 
Ministry of Health
Communications
250 952-1887 (media line)
 

 
Province of British Columbia
BACKGROUNDER 1
For Immediate Release
2020HLTH0257-001569
Aug. 21, 2020
Ministry of Health
What are biosimilars?
  • Biosimilars are highly similar versions of bioengineered drugs, known as biologics.
  • Biologics are expensive, injectable drugs made from living organisms (e.g., bacteria or yeast) and are used to treat a growing number of diseases from cancer to chronic conditions including arthritis, diabetes, and Crohn’s and ulcerative colitis.
  • Once patents for biologic drugs expire (20 years after patent was filed), other manufacturers can bring biosimilars onto the Canadian market, in a similar way to generic drug manufacturers.
  • Since biosimilars are based on work done to develop the original biologic drug, they require less research and development.
  • This means the biosimilar can be priced lower than the biologic – anywhere from 25% to 50% less – providing the same health benefits, for better value.
  • Biosimilars are approved for sale just as any other drug. 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.
  • Similarity between biologics and biosimilars is demonstrated using a step-wise approach beginning with structural and functional studies and continuing with human clinical trials and are evaluated to confirm that there are no clinically meaningful differences in safety and efficacy between them. 
 
Contact:
 
Ministry of Health
Communications
250 952-1887 (media line)
 

 
Province of British Columbia
BACKGROUNDER 2
For Immediate Release
2020HLTH0257-001569
Aug. 21, 2020
Ministry of Health
What other countries are doing with biosimilars

The Patented Medicines Price Review Board (PMPRB) has provided the following data on 2018 infliximab biosimilar use rates for Organisation for Economic Co-operation and Development countries.

Infliximab treats rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, and Crohn’s disease and ulcerative colitis. The legacy or reference biologic is called Remicade and the two biosimilars currently available in Canada are called Inflectra and Renflexis.

  • Norway: 98%
  • Poland: 96%
  • United Kingdom: 92% 
  • Austria: 89%
  • Italy: 79%
  • Sweden: 78%
  • Slovenia: 64%
  • Portugal: 63%
  • France: 60%
  • Czech Republic: 59%
  • Spain: 56%
  • Germany: 53%
  • Ireland: 40%
  • Korea: 37%
  • Slovakia: 36%
  • Belgium: 30%
  • Turkey: 23%
  • Switzerland: 22%
  • Mexico: 17%
  • Finland: 17%
  • Australia: 16%
  • Japan: 9%
  • Canada: 8%
  • United States: 7%
  • Chile: 0%
  • Hungary: 0%
  • New Zealand: 0%

Data source: MIDAS Database, prescription retail and hospital markets, Q4-2018, IQVIA.

 
Contact:
 
Ministry of Health
Communications
250 952-1887 (media line)
 

 
Province of British Columbia
BACKGROUNDER 3
For Immediate Release
2020HLTH0257-001569
Aug. 21, 2020
Ministry of Health
Rising cost of biologics
  • According to 2018 data from the Canadian Institute for Health Information, $14.4 billion of prescribed drug spending (42.7%) was financed by the public sector. Biologics used to treat conditions like rheumatoid arthritis and Crohn’s disease accounted for the highest proportion of public drug spending (8.2%) for the sixth consecutive year. Canadians with drug costs of $10,000 or more represented 2% of beneficiaries but accounted for more than one-third of public drug spending in 2017.
    Source: https://www.cihi.ca/en/health-spending/2018/prescribed-drug-spending-in-canada
  • According to the Canadian Agency for Drugs and Technologies in Health, many of the top selling biologic drugs already have or are expected to have biosimilars enter the market within the next few years. The European experience shows that increased biosimilar competition has not only affected the prices of the directly comparable biosimilars and their reference product, but also of the whole product class.
    Source: https://cadth.ca/sites/default/files/pdf/ES0317_biosimilars.pdf)
 
Contact:
 
Ministry of Health
Communications
250 952-1887 (media line)
 

 
Province of British Columbia
BACKGROUNDER 4
For Immediate Release
2020HLTH0257-001569
Aug. 21, 2020
Ministry of Health
New additions to PharmaCare formulary

This Biosimilars Initiative is allowing government to add new drugs to the PharmaCare formulary, meaning more people get affordable access to the medications they need. By using biosimilars in B.C., the Province will put about $96.6 million back into health care over the next three years to help fund coverage for more medications.

Recent additions have been made to the PharmaCare formulary under limited coverage. Limited coverage drugs are not generally considered to be first-line therapies or there are more cost-effective alternatives.

To be eligible for coverage of these drugs, the patient must meet criteria pre-defined by PharmaCare. Actual coverage depends on rules of the patient's PharmaCare plan, including any annual deductible requirement.

These recent additions to the formulary since May 2020 include:

  • Mepolizumab line extension for the treatment of asthma –
    Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction and easily triggered breathing spasms. Symptoms include episodes of wheezing, coughing, chest tightness and shortness of breath.
  • Glecaprevir+pibrentasvir (Maviret) criteria change for the treatment of Hepatitis C. –
    Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage.
  • Sarilumab (Kevzara) for the treatment of rheumatoid arthritis –
    Rheumatoid arthritis is a chronic inflammatory condition that primarily affects a person’s joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.
  • Inhaler coverage changes, including the addition of Trelegy Ellipta for the treatment of chronic obstructive pulmonary disease (COPD) –
    COPD is a type of obstructive lung disease characterized by long-term breathing problems. The main symptoms include shortness of breath and cough. COPD is a progressive disease, meaning it typically worsens over time. Many people have unrecognized COPD and remain undiagnosed.
 
Contact:
 
Ministry of Health
Communications
250 952-1887 (media line)
 

 
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