Biosimilars Initiative for patients

Last updated: December 1, 2023

To print this page, press CTRL+P.

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.

On this page:

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).

How do I keep my coverage?

  1. Make an appointment with your prescriber during the switch period.
  2. 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.
  3. Make sure you have a new prescription before the end of the switch period.

Transitional coverage of Humalog for patients using certain insulin pumps

6-month transitional coverage until May 30, 2024 is for:

  • Humalog®, for patients using Omnipod®, Ypsomed, and Medtronic pumps

This transition will allow people using the insulin lispro biosimilar (Humalog®) time to switch to the insulin lispro biosimilar (Admelog®).

Admelog® has been approved by Health Canada for use with these pumps and is a regular PharmaCare benefit. New approvals for insulin pumps will be expected to use Admelog®. 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®.

Coverage extension of NovoRapid for patients using certain insulin pumps

INSULIN PUMP USERS ONLY: Coverage extension for insulin aspart (NovoRapid®)
Insulin pump Rapid-acting insulin approved for compatible use PharmaCare coverage Conditions
Omnipod® NovoRapid® (insulin aspart originator— non-benefit) Until November 30, 2024 (extended)
  • type 1 diabetes
  • type 2 diabetes
Medtronic NovoRapid® (insulin aspart originator— non-benefit)
Ypsomed NovoRapid® (insulin aspart originator— non-benefit)
Tandem* NovoRapid® (insulin aspart originator— non-benefit)

*Tandem insulin pump is also approved for use with Admelog®.

Coverage is extended to November 30, 2024 for:

  • NovoRapid®, for patients using Omnipod®, Medtronic, Ypsomed and Tandem pumps

Effective November 30, 2023, PharmaCare will extend coverage for people currently covered for NovoRapid® insulin aspart originator who are using Medtronic™, Ypsomed, Tandem, and Omnipod® pumps. 

This coverage is being extended for 12 months to November 30, 2024 as 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.

Retail pricing for rapid-acting insulins

PharmaCare has also changed 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 covers all listed RAIs at the retail price. This includes the biosimilars and insulin glulisine (Apidra®). The change means patients are fully covered for RAIs and the full retail price counts towards any Fair PharmaCare deductible and family maximum, similar to all other insulin products covered by PharmaCare. They no longer have unexpected out-of-pocket costs.

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 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.

Drug decision summaries

Other resources

Additional reading




insulin aspart

insulin glargine

insulin lispro



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®
  • prevention and treatment of neutropenia
Phase One
(May 27, 2019 to November 25, 2019)
etanercept (Enbrel®) Brenzys®
  • ankylosing spondylitis
  • rheumatoid arthritis
  • ankylosing spondylitis
  • psoriatic arthritis
  • rheumatoid arthritis
infliximab (Remicade®) Inflectra®
  • ankylosing spondylitis
  • plaque psoriasis
  • psoriatic arthritis
  • rheumatoid arthritis
insulin glargine (Lantus®) Basaglar®
  • diabetes (type 1 and 2)
Phase Two
(September 5, 2019 to March 5, 2020)
infliximab (Remicade®) Inflectra®
  • Crohn’s disease
  • ulcerative colitis
Rituximab Phase
(August 20, 2020 to February 18, 2021)
rituximab (Rituxan®) Truxima®
  • granulomatosis with polyangiitis (GPA)
  • microscopic polyangiitis (MPA)
  • relapsing-remitting multiple sclerosis
  • rheumatoid arthritis
adalimumab (Humira®) and etanercept (Enbrel®)
(April 7, 2021 to October 6, 2021)
adalimumab (Humira®) Amgevita®

*Hadlima is currently not indicated for pediatric Crohn’s disease.
  • ankylosing spondylitis
  • Crohn’s disease
  • hidradenitis suppurativa (for adults)
  • plaque psoriasis (for adults)
  • polyarticular juvenile idiopathic arthritis
  • psoriatic arthritis
  • rheumatoid arthritis
  • ulcerative colitis
etanercept (Enbrel®) Brenzys®
  • plaque psoriasis (for adults)
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®
  • type 1 diabetes
  • type 2 diabetes
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®
  • prophylaxis and treatment of venous thromboembolism (VTE)
filgrastim (Neupogen®)
Biosimilar listed March 22, 2022. This is the second filgrastim biosimilar, and no switching is required for most patients.
filgrastim (Neupogen®) Nivestym™
  • prevention and treatment of neutropenia
adalimumab (Humira®)
Biosimilars listed August 18, 2022. No switching required.
adalimumab (Humira®) Hulio® 20 mg/0.4 mL prefilled syringe

*Simlandi and Yuflyma are high-concentration (100 mg/mL) doses. They are currently not indicated for pediatric Crohn's disease.
  • ankylosing spondylitis
  • Crohn’s disease
  • hidradenitis suppurativa (for adults)
  • plaque psoriasis (for adults)
  • polyarticular juvenile idiopathic arthritis
  • psoriatic arthritis
  • rheumatoid arthritis
  • ulcerative colitis
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
  • type 1 & 2 diabetes mellitus
enoxaparin (Elonox®)
Biosimilar listed June 1, 2023.
Lovenox®, Lovenox® HP Elonox®, Elonox® HP prophylaxis and treatment of venous thromboembolism (VTE)

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: