BC Becomes First in Canada to Adopt Biosimilars Over Biologics Under Public Health Plan

The BC government announced on May 27, 2019 that its PharmaCare public drug plan would cease covering three branded biologic drugs, and instead begin covering the biosimilar versions.
Categories: Employee Benefits
Jun 5th, 2019 | By: CapriCMW

The BC government announced on May 27, 2019 that its PharmaCare public drug plan would cease covering three branded biologic drugs, and instead begin covering the biosimilar versions.

Biologic drugs are produced from living organisms, and usually administered by injection or infusion to prevent and treat a number of diseases such as cancer, diabetes, cystic fibrosis, autoimmune disorders and more. Biosimilars are manufactured after the 20-year patent on the original biologics have expired. 

Currently, pharmacists cannot simply swap biosimilars for biologics, in the way that they can substitute traditional brand-name drugs with generic versions. Doctors must specifically prescribe the biosimilar. 

The three branded biologics (Janssen’s Remicade, Amgen’s Enbrel and Sanofi’s Lantus) that will be replaced by biosimilars under PharmaCare treat conditions such as arthritis, diabetes and Crohn's disease. There are approximately 20,400 patients currently on these biologics that will be required to switch to biosimilars by Nov. 25, 2019. Following that, the biologics will only be covered in exceptional circumstances on a case-by-case basis.

It is estimated that this shift in policy will save PharmaCare $96.6 million over three years, with biosimilars typically costing 25 to 50 percent less than original biologics. The savings will help fund coverage for two new biologic drugs. 

BC is the first province in Canada to adopt biosimilars over biologics, potentially paving the way for other jurisdictions in Canada to follow suit. There are currently 12 approved biosimilars in Canada, with another seven anticipated over the next few years. 

For more information and details, please see the Government of BC's official news release.

Contact a CapriCMW Advisor to discuss options for individual health or group benefits plans.

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