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.
This page has information for the general public. Health professionals, visit Biosimilars Initiative for health professionals
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The Initiative has successfully switched many PharmaCare patients to an equally safe and effective biosimilar drug approved by Health Canada. Biosimilars are less costly than originators, which 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. During that time, patients should talk to their prescriber to get a prescription for the biosimilar in order to keep their PharmaCare coverage. After the switch period ends, PharmaCare only covers the biosimilar version(s).
Patients who had PharmaCare coverage for Humalog®, and using Omnipod®, Ypsomed, Tandem and Medtronic™ pumps must have switched to the insulin lispro biosimilar Admelog® by May 30, 2024 to keep their coverage.
Admelog® was approved by Health Canada for use with these pumps and is a regular PharmaCare benefit. Coverage for patients newly starting on insulin pumps is expected to expand over time as insulin pumps get approval for use with insulin aspart biosimilars Kirsty™ and Trurapi®.
INSULIN PUMP USERS ONLY: Coverage extension for insulin aspart (NovoRapid®) | |||
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Insulin pump | Rapid-acting insulin approved for compatible use | PharmaCare coverage | Conditions |
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NovoRapid® (insulin aspart originator— non-benefit) | Until November 30, 2024 (extended) |
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Coverage is extended to November 30, 2024 for:
Health Canada has not yet approved these insulin pumps for use with the insulin biosimilars Trurapi® and Kirsty™, which are available in formulations that are regular PharmaCare benefits. PharmaCare anticipates Health Canada will approve these pumps for use with theses biosimilars by the end of the current extension.
The coverage extension to November 30, 2024 is automatic for people who had already qualified for the previous extension and still filling the originator insulin (to November 30, 2023), announced in May 2022, and doesn't require a Special Authority request.
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:
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 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.
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.
etanercept
infliximab
insulin aspart
insulin glargine
insulin lispro
rituximab
General
Since the Initiative was launched in May 2019, many PharmaCare-covered patients have successfully switched from an originator to an approved biosimilar:
Transition period (if applicable) | Drug (Originator) | Biosimilar(s) | Conditions include |
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filgrastim (Neupogen®) (January 31, 2017 to July 30, 2017) |
filgrastim (Neupogen®) | Grastofil® |
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Phase One (May 27, 2019 to November 25, 2019) |
etanercept (Enbrel®) | Brenzys® |
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Erelzi® |
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infliximab (Remicade®) | Inflectra® |
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Renflexis® | |||
insulin glargine (Lantus®) | Basaglar® |
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Phase Two (September 5, 2019 to March 5, 2020) |
infliximab (Remicade®) | Inflectra® |
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Renflexis® | |||
Rituximab Phase (August 20, 2020 to February 18, 2021) |
rituximab (Rituxan®) | Truxima® |
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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. |
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etanercept (Enbrel®) | Brenzys® Erelzi® |
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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® |
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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® |
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filgrastim (Neupogen®) Biosimilar listed March 22, 2022. This is the second filgrastim biosimilar, and no switching is required for most patients. |
filgrastim (Neupogen®) | Nivestym™ |
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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. |
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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 |
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enoxaparin (Elonox®) Biosimilar listed June 1, 2023. |
Lovenox®, Lovenox® HP | Elonox®, Elonox® HP |
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Insulin glargine (Semglee®) Biosimilar listed on May 25, 2023. No switching required |
insulin glargine (Lantus®) | Semglee® |
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Filgrastim (Nypozi) Biosimilar listed on May 14, 2024 |
filgrastim (Neupogen®) | Nypozi |
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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) |
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Denosumab (Jubbonti®) (August 29, 2024 to March 3, 2025) |
denosumab (Prolia®) | Jubbonti® |
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Denosumab (Wyost™) (August 29, 2024 to March 3, 2025) |
denosumab (Xgeva®) | Wyost™ |
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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.
If you have questions, contact the Biosimilars team by: