Biosimilars Initiative for Patients
The Biosimilars Initiative was launched in 2019 to expand health care services in B.C. by switching patients from originator biologic drugs to biosimilar versions shown to be as safe and effective (see Originator biologics vs. Biosimilars below).
Since its launch, the Initiative has successfully switched many PharmaCare patients to an approved biosimilar drug. Biosimilar drugs are approved for use by Health Canada and are as safe and effective. Switching to biosimilars, which are less costly than originators, means that B.C. can spend money in other areas of our health care system. For example, PharmaCare will be able to cover more drug options.
Each switch period is six months. If you are taking one of the originator drugs and it is covered by PharmaCare, and you don’t want to lose your coverage, speak to your prescriber before the switch period ends. Your prescriber can write you a new prescription for the biosimilar, and your coverage will continue. After the switch period ends, PharmaCare only covers the biosimilar version(s).
For any questions, visit our Biosimilars FAQ for patients or contact us.
Current switch period
| Switching insulin lispro (Humalog®) and insulin aspart (NovoRapid®): November 30, 2021 to May 29, 2022 |
|||
|---|---|---|---|
| Drug | Originator | Biosimilar | Conditions include |
| insulin lispro | Humalog® | Admelog® |
|
| insulin aspart | NovoRapid® | Trurapi® | |
On November 30, 2021, Admelog and Trurapi are added as regular benefits on the PharmaCare formulary. Beginning December 15, 2021, PharmaCare no longer covers Humalog and NovoRapid for new patients. Only the biosimilar versions (Admelog or Trurapi) will be covered by PharmaCare if you are starting on insulin lispro or insulin aspart after December 15.
During the six-month switch period, from November 30, 2021 to May 29, 2022, PharmaCare will cover both the originator and biosimilar options for patients currently taking insulin lispro (Humalog) and insulin aspart (NovoRapid). The switch period will provide time to get informed, talk to your pharmacist, start the switching process with your prescriber, and if applicable, obtain a new insulin pen. New pens may be ordered free of charge from a pharmacy or by contacting Sanofi.Diabetes@SanofiCanada.com.
Effective May 30, 2022, PharmaCare will no longer cover Humalog and NovoRapid.
If you had coverage for Humalog Mix25, Humalog Mix50 or NovoMix 30 before December 15, 2021, your coverage will not be affected; you will not need to switch.
Retail pricing for rapid-acting insulins
PharmaCare is also changing its pricing policy for rapid-acting insulins (RAIs), including the newly added biosimilars. Previously, all RAIs were covered up to a certain amount only. This meant that patients had to pay costs above that amount.
As of November 30, 2021, PharmaCare will cover all listed RAIs at the retail price. This includes the biosimilars and insulin glulisine (Apidra®). The change means patients will be fully covered for RAIs and the full retail price will count towards any Fair PharmaCare deductible and family maximum, similar to all other insulin products covered by PharmaCare. They will no longer have unexpected out-of-pocket costs.
| Switch period | Drug (Originator) | Biosimilar(s) | Conditions include |
|---|---|---|---|
| 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 not indicated for pediatric Crohn’s disease. |
|
| etanercept (Enbrel®) | Brenzys® Erelzi® |
|
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.
Through biotechnology, biologic drugs are created from living organisms like yeast and bacteria. Biologics treat patients with serious chronic conditions, including some autoimmune diseases. The first version of a biologic developed is known as the “originator or reference drug.” This is because they are the original 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 large and complex, biosimilars can be highly similar, but not identical. Many studies compare biosimilars to the originator drugs and find them to be as safe and effective. Originator drugs have already set the foundation of research and development for biosimilars, which means biosimilar drugs are more cost-effective to produce and lead to similar outcomes.
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.
If the Biosimilars Initiative affects you:
- Make an appointment with your prescriber during the switch period
- Discuss the switch with your prescriber and pharmacist (only your prescriber can write you a new prescription)
- Your prescriber can explain the switch process, discuss your biosimilar option(s), and write you a new prescription
- Make sure you have a new prescription before the end of the switch period in order to keep your PharmaCare coverage
Biosimilars patient information sheets
Drug Decision Summaries
Other resources
- Health Canada Fact Sheet: Biosimilars
- International Coalition of Medicines Regulatory Authorities Biosimilars Statement (PDF, 625KB)
- Arthritis Consumer Experts Biosim Exchange
- Arthritis Society: Biologics/Biosimilars for the Treatment of Inflammatory Arthritis
- Canadian Digestive Health Foundation
Additional reading
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 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
adalimumab
- CADTH: Switching from reference to biosimilar adalimumab for patients with various inflammatory conditions
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
- NOR-SWITCH study: non-medical switching for all indications, originator infliximab to biosimilar
insulin glargine
- Clinical study: Switching to Insulin Glargine Biosimilar
- Clinical study: Similar efficacy and safety between insulin glargine biosimilar and biologic (Lantus)
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
- A randomised, double-blind trial to demonstrate bioequivalence of GP2013 and reference rituximab combined with methotrexate in patients with active rheumatoid arthritis
General
- Biosimilars in the EU: Information Guide for Healthcare Professionals
- Patient information: How Biologics and Biosimilars Work
- Drug Discontinuation in Studies Including a Switch from an Originator to a Biosimilar Monoclonal Antibody: A Systematic Literature Review
- Switching Reference Medicines to Biosimilars: A Systematic Literature Review of Clinical Outcomes
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