Biosimilars Initiative for patients
Last updated on May 27, 2025
This page has information for the general public. Health professionals, visit Biosimilars Initiative for health professionals
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The Biosimilars Initiative transfers PharmaCare coverage from originator biologic medications to equally safe and effective biosimilar versions.
Biosimilars cost less than originator biologics. In the first five years of the Biosimilars Initiative, which launched in 2019, B.C. has saved $732 million. The savings have been reinvested in PharmaCare coverage of other drugs and medical devices, such as continuous and flash glucose monitors, inhalers for chronic obstructive pulmonary disease, the drug dapagliflozin to treat type 2 diabetes and heart failure, and Trikafta to treat cystic fibrosis.
Over 40,000 B.C. residents have switched from an originator biologic to a biosimilar.
Six-month switch period
Once PharmaCare decides to cover a Health Canada-approved biosimilar, patients have six months to transition from the originator biologic version, to keep their PharmaCare coverage. After the switch period ends, PharmaCare only covers the biosimilar version(s).
How to keep PharmaCare coverage
- Make an appointment with your prescriber during the six-month switch period.
- Your prescriber can explain the switch process, discuss your biosimilar option(s), and write you a new prescription. You may also want to talk to your pharmacist.
- Make sure you have a new prescription before the end of the switch period.
Coverage of NovoRapid continues for patients using Omnipod, Medtronic, Ypsomed, Tandem
NovoRapid® (insulin aspart originator— non-benefit) continues to be covered for patients who already have coverage, who are using Omnipod®, Ypsomed, Tandem and Medtronic™ pumps for type 1 and type 2 diabetes. Special Authority coverage will renew automatically for these patients.
Coverage is subject to change pending future reviews of biosimilar insulin aspart formulations. If coverage does change, PharmaCare will provide a transition period during which patients can switch to a biosimilar without losing coverage.
How can I make sure the switch goes well for me?
Your mindset can influence your symptoms and sense of well-being. The nocebo effect is when negative expectations lead to negative outcomes. Misinformation from a variety of sources can cause nocebo effect.
To combat a potential nocebo effect, you can:
- Acknowledge the nocebo effect
- Seek out more information on biosimilars
- Speak to your pharmacist or doctor about the switch and your biosimilar options
- Keep a neutral or positive outlook
What if I can’t switch to a biosimilar?
Some patients cannot switch to a biosimilar for medical reasons. Your prescriber can help you determine if it is medically necessary for you to remain on the originator medication. If it is, they can submit a Special Authority (SA) request asking PharmaCare to consider continued coverage of the originator. Exceptional requests are considered on a case-by-case basis.
Can I still switch if the switch period has ended?
Yes, you can switch anytime, but coverage is not retroactive. You would be paying full price for the originator. If you would like to switch to the covered biosimilar, talk to your prescriber.
Biologic drugs are created from living organisms like yeast and bacteria. The first version of a biologic is known as the “originator or reference drug.” This is because they are the original biologic version of a drug that a biosimilar is based on.
As patents expire for originator drugs, other manufacturers may produce new, similar versions. These new versions are called biosimilars. Since originator drugs are complex, biosimilars can be highly similar but not identical. Many studies comparing biosimilars to the originator drugs have found them to be as safe and effective.
There are very small differences between different batches of an originator drug. This is because they are made using living organisms with some tiny natural differences. The same goes for the slight differences between a biosimilar and its originator drug, which are also not clinically meaningful.
Drug decision summaries
Visit Drug review decisions to access a searchable table that lists drug decision summaries.
Other resources
Additional reading
etanercept
- Clinical study: Non-medical switch from originator etanercept to biosimilar (rheumatology)
infliximab
- Clinical study: Non-medical switch from originator infliximab to biosimilar (rheumatology)
- ECCO: Position Statement on the Use of Biosimilars for Inflammatory Bowel Disease
- Efficacious transition from reference infliximab to biosimilar infliximab in clinical practice
insulin aspart
- CADTH: Switching from Reference to Biosimilar Insulin Aspart for Patients with Diabetes Mellitus (Type 1 or 2)
- Efficacy and Safety of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Treated for 26 Weeks with Multiple Daily Injections in Combination with Insulin Glargine: A Randomized Open-Label Trial (GEMELLI 1)
- Efficacy, Safety, and Immunogenicity of Insulin Aspart Biosimilar SAR341402 Compared with Originator Insulin Aspart in Adults with Diabetes (GEMELLI 1): A Subgroup Analysis by Prior Type of Mealtime Insulin
- Safety and Tolerability of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart (NovoLog) When Used in Insulin Pumps in Adults with Type 1 Diabetes: A Randomized, Open-Label Clinical Trial
insulin glargine
- Clinical study: Switching to Insulin Glargine Biosimilar
- Clinical study: Similar efficacy and safety between insulin glargine biosimilar and biologic (Lantus)
insulin lispro
- CADTH: Switching from Reference to Biosimilar Insulin Lispro for Patients with Diabetes Mellitus (Type 1 or 2)
- Efficacy and Safety of Biosimilar SAR342434 Insulin Lispro in Adults with Type 1 Diabetes Also Using Insulin Glargine-SORELLA 1 Study
- Efficacy and Safety of Biosimilar SAR342434 Insulin Lispro in Adults with Type 2 Diabetes, Also Using Insulin Glargine: SORELLA 2 Study
- Safety of Insulin Lispro and a Biosimilar Insulin Lispro When Administered Through an Insulin Pump
rituximab
- Efficacy and safety of switching from rituximab to biosimilar CT-P10 in rheumatoid arthritis
- Long-term efficacy and safety of biosimilar CT-P10 versus innovator rituximab in rheumatoid arthritis
- Comparison of biosimilar CT-P10 and innovator rituximab in patients with rheumatoid arthritis
- A phase I pharmacokinetics trial comparing PF-05280586 (a potential biosimilar) and rituximab in patients with active rheumatoid arthritis
- Comparative assessment of clinical response in patients with rheumatoid arthritis between PF‐05280586, a proposed rituximab biosimilar, and rituximab
- Extension Study of PF-05280586, a Potential Rituximab Biosimilar, Versus Rituximab in Subjects With Active Rheumatoid Arthritis
General
- Biosimilars in the EU: Information Guide for Healthcare Professionals
- Switching Reference Medicines to Biosimilars: A Systematic Literature Review of Clinical Outcomes
Since the Initiative was launched in May 2019, many PharmaCare-covered patients have successfully switched from an originator to an approved biosimilar:
- Phase One - 73% of patients transitioned
- Phase Two - 78% of patients transitioned
- Over 90% of PharmaCare patients taking infliximab, etanercept and insulin glargine are now taking biosimilars
| Transition period (if applicable) | Drug (Originator) | Biosimilar(s) | Conditions include |
|---|---|---|---|
| filgrastim (Neupogen®) (January 31, 2017 to July 30, 2017) |
filgrastim (Neupogen®) | Grastofil® |
|
| Phase One (May 27, 2019 to November 25, 2019) |
etanercept (Enbrel®) | Brenzys® |
|
| Erelzi® |
|
||
| infliximab (Remicade®) | Inflectra® |
|
|
| Renflexis® | |||
| insulin glargine (Lantus®) | Basaglar® |
|
|
| Phase Two (September 5, 2019 to March 5, 2020) |
infliximab (Remicade®) | Inflectra® |
|
| Renflexis® | |||
| Rituximab Phase (August 20, 2020 to February 18, 2021) |
rituximab (Rituxan®) | Truxima® |
|
| Riximyo® | |||
| Ruxience™ | |||
| adalimumab (Humira®) and etanercept (Enbrel®) (April 7, 2021 to October 6, 2021) |
adalimumab (Humira®) | Amgevita® Hadlima®* Hulio® Hyrimoz® Idacio® *Hadlima is currently not indicated for pediatric Crohn’s disease. |
|
| etanercept (Enbrel®) | Brenzys® Erelzi® |
|
|
| insulin lispro (Humalog®) and insulin aspart (NovoRapid®) (November 30, 2021 to May 29, 2022 with extensions given to some patients using insulin pumps as compatibility was not initially approved by Health Canada) |
insulin lispro (Humalog®) | Admelog® |
|
| insulin aspart (NovoRapid®) | Trurapi® | ||
| enoxaparin (Lovenox®) Biosimilars listed March 22, 2022. No switching required. Existing PharmaCare patients taking Lovenox keep their currently approved coverage until it expires. |
enoxaparin (Lovenox®, Lovenox® HP) | Inclunox®, Inclunox HP® Noromby®; Noromby HP® Redesca®, Redesca HP® |
|
| filgrastim (Neupogen®) Biosimilar listed March 22, 2022. This is the second filgrastim biosimilar, and no switching is required for most patients. |
filgrastim (Neupogen®) | Nivestym™ |
|
| adalimumab (Humira®) Biosimilars listed August 18, 2022. No switching required. |
adalimumab (Humira®) | Hulio® 20 mg/0.4 mL prefilled syringe Abrilada® Simlandi™* Yuflyma™* *Simlandi and Yuflyma are high-concentration (100 mg/mL) doses. They are currently not indicated for pediatric Crohn's disease. |
|
| insulin aspart (NovoRapid®) Biosimilars listed January 24, 2023. No switching required for most patients. |
insulin aspart (NovoRapid®) | Kirsty® 100 units/mL in a 3 mL pre-filled pen |
|
| enoxaparin (Elonox®) Biosimilar listed June 1, 2023. |
Lovenox®, Lovenox® HP | Elonox®, Elonox® HP |
|
| insulin glargine (Semglee®) Biosimilar listed on May 25, 2023. No switching required |
insulin glargine (Lantus®) | Semglee® |
|
| filgrastim (Nypozi) Biosimilar listed on May 14, 2024 |
filgrastim (Neupogen®) | Nypozi |
|
| ustekinumab (Jamteki™, Steqeyma® and Wezlana™ ) (May 30, 2024 to December 2, 2024) |
ustekinumab (Stelara®) | Jamteki™ Steqeyma® (as of September 17, 2024) Wezlana™ (as of September 17, 2024) |
|
| denosumab (Jubbonti®) (August 29, 2024 to March 3, 2025) |
denosumab (Prolia®) | Jubbonti® |
|
| denosumab (Wyost™) (August 29, 2024 to March 3, 2025) |
denosumab (Xgeva®) | Wyost™ |
|
| tocilizumab (Tyenne®) (May 27, 2025 to November 27, 2025) |
tocilizumab (Actemra®) | Tyenne® |
|
Note: On February 18, 2021, the PharmaCare formulary added Brenzys for the treatment of psoriatic arthritis and the biosimilar infliximab, and Avsola™ for the treatment of ankylosing spondylitis, plaque psoriasis, psoriatic arthritis, and rheumatoid arthritis.
Biosimilars patient information sheets
Contact
If you have questions, contact the Biosimilars team by:
- Phone: 1-844-915-5005 (Monday to Friday, 8:30 am to 4:30 pm)
- Email: Biosimilars.Initiative@gov.bc.ca